70931 7614 Barnhart Place -;1,0"3/
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR GAS PERMIT
NOV 20 1961 //77
Date-----.........................---------....---- 19.......... Permit No......w � ....
The un rsirand
p Plumbing Inspector of the City
of San J i to a' appliances and/or gas pipes as listed on the
reverse side hereees to install said appliances and/or pipes in accordance
with the provisio VIII, Chapter 4, of the San Jose, Municipal.Code, and
other laws applicake thereto.
I certify that erforman f e/�+'�It {dr c permit is issued I
shall not emplo son inabA�r s/cis the workmen's com-
pensation laws f ifornia.
OWNER (.. �.- ���...... ------
ADDRESS ------ G ---f/- .--------------------- ------------------------,.. ..................
USE OF BUILDING ----- .. .......... ......... --
FORM 280-20 4/e7 IOM Signed -.-MERCURYSHEET METAL -- ITMI G,.INC
Mercury
761.4 Barnhart Place
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