80826 2917 Newcastle Drive
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR GAS PERMIT
Date �.. ��------------------- --- 19.Z. .. Permit No-----1?.1s. ..4�.-------
The undersigned eby,Pees
p 'cat' n-�a 11bing Inspector of the City
of San Jose fora er lid a /or gas pipes as listed on the
reverse side hereo and atoinstall said appliances and/or pipes in accordance
with the provisions of Article VIII, CCap�G�' 4, o the San Joj�.. uniCipal Code, and
other laws applicable thereto. /J5 t /���y`-
certify that in the perform ce o fhe wor f r wh 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.... ..H.....✓C/.. ._.........._.... .............. - .- -----------------------------
ADDRESS
----_----------- ------ --ADDRESSJ� --`ic / - -- LOT NO..SY....
USE OF BUILDING..-�L... -:-
_...---_._.___......M_.& M SHEET METAL
701-248 KINGS ROW
__ .. . . ..
28020 (Rev. Apr. 691 Signe :... --....---....----------...---"---
- .. . - -- -- - - --
- �-'----- SAN JOSE. CAIIF. 95112
2917 Newcastle Drive M&M _Sheet Metal
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