51145 (2)LOT NO.a-17
NO. STREET
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ON FOR GAS PERMIT
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W .MAR 2 2 1966
< Ua/t+eTT (n�[ /�I p p nI(� 196_ Permit No.
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li n t e the City of Cupertino for a permit to install gas pipes
o and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
r and/or appliances in accordance with the provisions of the Plumbing Code of the City
< W of Cupertino, and all other laws applicable thereto.
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a° State LicenseC %3o O ApprovedWILL1AM D. 13ENEVICH0 /
- VII PLUMBING INSPECTOR
of Appliance I Units Fees
NAME. TYPE.
HOUSE GAS PIPING
Number of Outlets Size of Main
Gas Piping Fees
Tested and Approved .. .............. _......................----...._......... _.._._.
DATE. INSPECTOR
A
aft
LOT NO._
NO. STREET
W_�tmN FOR GAS PERMIT
OF CUPERTINO
6Z0 3 i Uate— Permit No.
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A scat to the Cit of Cu ertino for ermn to install aca es
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and/or gas appliances as listed on the reverse side hereof, and agrees to install said pipes
and/or appliances in accordance with the provisions of the Plumbing Code of the City
of Cupertino, and all other laws applicable thereto.
Owner
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of Appliance I Units Fees
rnaces
NAME TYPE)
HOUSE GAS PIPING
Number of Outlets Size of Main
Gas Piping Fees
Tested and Approved ....... ...............
DATE INSPECTOR