579 1-i!yam/�/ 9. �.Ci/✓t Y Cls �/✓ �✓ LOT NO.
NO. STREET
T21 U .R APPLIANCE PERMIT
OF CUPERTINO
J lJ1961 . Q
Date_ �%T8
/ v '_:196. .- Permit No:
CITY .OF CUPERT/INO` � Fee
Application is hereby made,roJhe City of Cupertino for a permit tgjgIstall:4";.i
ti:+ .,
,O gas appliances•as'listed on the reverKe side hereof, and agrees to install'said
- Kappliances in accordance withth ;.p%isions of the Plumbing r:odeofAhe,'City,, '
of Cupertino, and all other lawsyapplicable thereto.
X% ` Useof�Piemises f"'
c�
Owner�� Address_ .
��, W fY \ 1. •FM.
Address - -
TOR AGENT ':' v-
ING & SHEET- 1dETAt CO. Approved
"•:�'.
180`..`SQRNYISARS�IV��RAIPBELLruF— PLUMBING INSPECTOR
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0 7 y.
t �� ,}1 �•�• i lei -�I I I A -I ._ L. I I• I I i l l
GAS SERVICE.' TlC OFFICE
l]] COPY
' BUILDING INSPECT R'� OhI'I L''' ; '+
CITY-,OE CUPS T[Nti,
, t9G�
_ You;are hereby authorized to connect the GAS service for,
/f� t
Owder or Tenant . - t=f%4 1. 16G! . _ ._
At
New Service�'.
No: of Meters ..... ---.----- Reconnect
.. - Move Service .' .__,',' .
I
No. of Add. Meters -------------- Move Meter " FS
-I A 1
i ;PLUMBING TNSPECTORr
110 1/60-500