82146 8077 Park Villa Circle
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR GAS PERMIT
Date,-_...FEB...1....-.--972........... 19.--....... Permit
No... . .2_/.( -.-f;.....--- .
The
to
r of
of San Joserfor adperrrmji ofoOins}all a d ep�p mo este Igor�gas pipesaslistedhonCthe
reverse side hereof, and agreelto install said appliances and/or pipes in accordance
with the provisions of Article VIII, Chapter, 4, of the San Jose Municipal Code, and
other laws applicable thereto. �� ��'( ���
I certify that in the performance of t'he work for which this permit a 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
. . - . _-- ............. ........ -... _
Q-. ... ._._... ......... _
....-.. ... .... ...........
ADDRESS J�r/ nn --� .-...._.. LOT NO.._Q-- ..
USE OP BUILDINGRESIDENCE
MERCURY SHEET METAL�Ze� ! �f
280-20 (Rov. Apr. b'�) Signed...._-------------------------- -- -- - ---- ----��- - �-- ------ .. .
8077 Park Villa Circle Mercury Sh tcgetal
Type of Appliance No. Remarks (Check V)
New Replace Relocate
Gas Ranges
Wall Heaters
Gas Plates
Circulating Heaters
Blower Furnaces _
Gas Fired Boilers
Warming Ovens
Percolators
_Griddles
Steam Tables
Gravity Furnaces
Suspended Unit
Floor Furnace
Automatic Controls
Flue and/or Vent
Hood and/or Duct
Clothes Dryer
Permit Fee
a,
TOTAL �o
FEE
Inspected and Approved Z VBy �;Oq
HOUSE GAS PIPING f
Number of Ou+lefsl Size of Main
FEE
Tested and Approved By