80432 937 -Liberty Cour;t "
CITY OF SAN JOSE BUILDING DEPARTMENT
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APPLICATION FOR GAS PERMIT
Date.....7_-../2...............`..... 19_�;?Z Permit No.S. ..�-. - ---..
The undersigned here. makes ap lic 'on to the Plum g Inspector of the City
of San Jose for a perg�%� �/r1 nc n as pipes as listed on the
reverse side hereof, a a re to in al s d nc and/or pipes in accordance
with the provisions of Article VIII, Chapter of the San Jose Municipal Code, and
other laws applicable thereto. � /� �7 /��
I certify that in the performance oft for i i p rm i d I
shall not employ any person in any manner so as to violate the workmen's com-
pensation laws of California.
OWNER. AGN......� ..... oliG - -- ........._-----------------------
ADDRESS... 3..7__G.// / 7f......CT............. LOT NO.--------------
USEOF BUILDING....�4i7�-------- .............__._.... ........-- . ._..... ........ ......
280-20 (Rev. Apr. 69) Signe - _--...._-.. _..
937 Liberty Court Gould
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