82148 8059 Park Villa Circle
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR GAS PERMIT
Date... /� �/
FEB.,-----.-.1972..... 19-------.- Permit No._?�� ..P..............
.--. .... -------
The undersigned hereby�naakes,/p? .Iicafionrt�ihdV1umi ing Inspector of the City
of San Jose for a p�erfnifitoe"11�5atidaapplianceand�or gas pipes as listed on the
reverse side hereof, and agrees to install said appliances and/or pipes in accordance
with the provisions of Article VIII, Chapte4�f.the ��n JosMyn'ic_ipal Code, and
other laws applicable thereto. �`1S(! �
I certify that in the performance of he work for whit this 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-MACKAY--HOMES-----------------
....-----........ - - - -
ADDRESS(J-. ...... LOT NO._.O.-L..
USE OF BUILDING -RESIDER C
- _ ...-E............ ........... pt �4
280-20IRev. Apr. 691 Signed MERCURY_-SHEI;L.METAL. �� _- --8059 Park Villa Circle Mercury Shetal
Type of Appliance No. Remarks (C eck V)
New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates -
Circulating Heaters
Blower Furnaces oJ',�
Gas Fired Boilers
.tWarming Ovens
Percolators
Griddles
Steam Tables
Gravity Furnaces
Suspended Unit
Floor Furnace
Automatic Controls
Flue and/or Vent —
Hood and/or Duct
Clothes Dryer
Mand
�_d ` - �jJ2- By,
HOUSE GAS PIPING
Number of Outletsj Size of Main
FEE
Tested and Approved By