1074 (2) 7 '1 .6 LOT NO. Id
NO. STIBRT
Y APPL`ICATI0NfOR APPLIANCE PERMIT
I11 OF CUPERTIN0
f QFC �'
Date ��� 17 1962 196.`y Permit No._—LD
CITY Or CUPERTINO Fee s
Application is hereby made to the City of Cupertino for a permit to install
gas appliances as listed on the reverse side hereof, and agrees to install said
appliances in accordance with the Provisions of the Plumbing rode of the City
of Cupertino, and all other laws applicable thereto.
:7 Use of Premises
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J, Owner _ Address*PLUMBING
AddressApprovP TO
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