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LOT NO.
A'PPL'ICAT N OR GAS, PERMIT
CITIYYUOP CUPERTINO
`JUL 29 1963 L
Date 196 Permit No. e� "7 "'
CITY OF CUPERIINOso
Per S_
Application is hereby made to the City of Cupertino for a permit to install gas pipes
and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
and/or appliances in acctr ante with the provisions of the Plumbing Code of the City
of Cupertino, and all otl aws �Fplicable thereto.
Use of
13y/�1 f % U� /f'I U C.es ,
T CONT ACTOR, AGENT
Phone 116 7--(ei2- 2—
State License %S 7ole2 11
Address,/04.po
Addre CCeI� �• V
k, ::—,a
Approve
PLUMBING INSPECTOR
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