2130 NO.
S HeT
A;PiIC�TION FOR GAS PERMIT
W'= TY OF CUPERTINO
Yin,: +SJAN.3° X863
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ew Ul O
3 u""`Date• r ': .'rA'(�,196 �,,�P.e�t Now°�-x O
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TY OrR1AtitY1�— " __ Fe $t'
°" - .Application u hereby,made:to the C+tyrioF Cupeihino:for T permit to install gas pipes
o-a�and%or gas.appliapces.als listed on the ieverse side hereof, and agreesrto install said pipes
r,� and%or
app liances,,inritccordance,;,wi6fi'i&_provisions of dte,.Plumbing Code of the City
<� of Cuperti o and all-other law a pltcable;the'reto.
�. Use Pre ises
o,"z Owner Address.
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Jz Bv Address
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m Phone. r1W Z
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0 State License �� f �_ Approved
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.. .. .OFFICE
COPY
7� GAS -SERVICE 'NOTICE
/✓�yJ BUILDING..INSPECTOR'S OFFICE
CITY OF CUPERTINO
...-�....��.-`------. ------, 1963..
To
You are herebyautl ed to watt the rvic o
Owner or Tenant .... ..
_.. .
At // ppqq
'... No. of Meters, .. .. e nnec
44.
ic
No' +Move Metdrr,
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PL
UIvlEln(j) INSPECtIOR
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