76690 858 East Estates Dr C
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR GAS PERMIT
Date----- --1�' .-. ..."Y9'....--.. Permit No....._7K6 ( C1-------------
The undersigned re y �AghliRaf I' t e Plumbing Inspector of the City
of San Jose for s p' n s and/or gas pipes as listed on the
reverse side here ,"and to install said appliances and/or pipes in accordance
with the provisions of Article %II bapter of�h�Asn/J�ese icipal Code, and
other laws applicable theret J x/ pll' (/e/
I certify that in the performance of the work for which is permit is issued I
shall not employ any person in any manner so as to violate the workmen's com-
pensation laws of California.
OWNER....!?� ----X72.....--o ! Q S---------
............---------- .._---------
ADDRESS- ---_C SS....ES.Ti s---.n/?.:... ... ....., LOT NO.9L-------
USE OF BUILDING- -
...._.... ..... .... ......
/ O1/ -------------------------------
280-20 (Rev. Apr. 69) Signed...... ... ..may-.�----- �- - -'-rq�
858 East, Estates Dr Jones
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