723 (2) LOT Nq.
NO. STREET
APPLICATION FOR GAS PERMIT
CITY OF CUPERTINO
Date 195_ PermitNo. 7� '
Fee
Application is here b de o ' 0,,
f u fora permit to install gas pipes
and/or ps WR GIBn e s s�le a and agrees to install said pipes i
and/or appliances in a or c o,lfi�i s f. he Plumbing Code of the Cityof Cupertino, an� all �i`ereto.
Use of Premises . 1
4A M1lOwne %� %�•i Address
Addressf ,
CONTRACTOR, AGENT
Phon f / 2_� G Approbe
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PLUMBING INSPECTOR: "•�
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