80340 7485 Prospect Road
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR GAS PERMIT
> Date.... - ...- -•��----------- 19...7 . Permit No.....---
The ndersigned hereby mpkes applin Jose for a permffccatiog-toof 4't
e Rlu"bing Inspector of the City
ianfes
�or gas
es
isted on the
rreverse side hereof, and t gree�to�'s allsaaid-1a FNa ces and/or sin accordance
9 �� PP pipes
with the provisions of Article VIII, Chapter 4, of the San Jose Municipal Code, and
other laws applicable thereto. 2 / Iy�-R n
I certify that in the performance of f1h work for�hJch�t�i'e�pecmit is issued
shall not employ any person in any manneIF r so as to violate the,(workmen's com-
pensation laws of California. �"
OWNER.----V2y ..-"--�Q'1Y,5/-- . ....._.. --------------1....- --------- ----------- ----------------
ADDRESS....-----7,414f Q/ 0r.P.ec..T... 2
P.. ....................... LOT NO.--------------
USEOF BUILDING--... EC.<. a r .................._...... """........._..........:. ........._._....
- --
Signed,� _------- ------ -
280-201Ray. Apr. 691 - -- - ' -----""" .
L&L
7485 Prospt Ro
ecad
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