71337 1697 Calaway *y/
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR GAS PERMIT 7 7
Date.......:.JAN_U 196.R........... 19.......... Permit No------7.1.1.1.---7.........
The undersigned here y makes a plication to the Plumbing Inspector of the City
of San Jose for a per a I' 91or gas pipes as listed on the
reverse side hereof, agr es to s a sat appliances and/or pipes in accordance
with the provisions of thereto.VIII, p>+�,y4, of e S se Municipal Code, and
other laws applicable thereto. {{-����ii h��Cf��t'�
certify that in the performan o the wok for w is s 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 --- ? -------
ADC
-----ADDRESS Io. . - .. .. . ,4..... ------------------------
USEOF BUILDING ... a.._ . . 4r.G_,.---....-------------------------------
FORM 280-20 4/67 IOM Signed .........MERCURY SHEET METAL. &..HEATING,. . ..INP
. ....... ... ......... "' .. . .........
1697 Galway Mercury
Type of Appliance No. Remarks (Check
New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters
Blower Furnaces �. ad
Gas Fired Boilers
Warming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit
Floor Furnace
Automatic Controls
Flue and/or Vent o .off
Hood and/or Duct
Clothes Dryer
Permit Fee
TOTAL Spm
FEE
Inspected and Approved-/J�faq Bye ,-,,-�
HOUSE GAS PIPING
—
Number of Outlefsj Size of Main
FEE
Tested and Approved By