71337 1685 OaNway
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR GAS PERMIT
2 5 ) �
Date.... JAN- ................ 1968-------- 9.......... Permit No..._/�.`/. -/7
The undersigned her male a Ii ion t the ing Inspector of the City
of San Jose for a pe i� r6gas pipes as listed on the
reverse side hereof, n a es to insta aid appliances and/or pipes in accordance
with the provisions of Article VIII, apte 4, of the San Jose Municipal Code, and
other laws applicable thereto. �/��
I certify that in the performance o the worn for whit p rmif is issued I
shall not employ any person in any manner so as to violate the workmen's com-
pensation laws of California.
OWNER
OWNER ..LLLCa .. ..
... ..16`x' _ -c-r.cv-------
ADDRESS u' ....................
USE OF BUILDING ..... �.. ......y`'�e.............................................
FORM 280-20 4/67 loy Signed .-_._MERCURY SHEET METAL & HEATING, Il
1685 GaWay Dr qr ry
Type of Appliance No. Remarks (Check V)
=Replace
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters
Blower Furnaces , 0
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit
Floor Furnace
Automatic Controls
Flue and/or Vent . OU
Hood and/or Duct
Clothes Dryer
Permit Fee °
TOTAL
FEE
Inspected and Approved/p i`
,Z(,5;7 By
HOUSE GAS PIPING
Number of Outletsi Size of Main
FEE
Tested and Approved By