71338 7337 Prospect Rd %L
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR GAS PERMIT
Date.....JAN 2-5..196H----........ 19-------.. Permit No./..�� ...................
The undersigned hereby makes application to the Plumbing Inspector of the City
of San Jose for a�p'e it to�Ya`I�"sa`2 ap-pplia cds,and�or gas pipes as listed on the
reverse side hereof�nd�greesffol stallisaidrppliences and/or pipes in accordance
with the provisions of Arr{icle VIII, Chapter 4, of the San Jose Municipal Code, and
other laws applicable.thereto, q��—' T
I certify that in the performance of Jhre�.,w ork for Rhicy�Operm!fi� issued I
shall not employ any person in any manner -- as to Yiolate the workmen's com-
pensation laws of California.
OWNER ...�Lj1L...:. . ...... - ..........-----
ADDRESS /.7 `�� �w e�oC ..........................
USEOF BUILDING ...._.. .....................................
MERCURY SHEET METAL & HEATING, INC
FORM 280-20 4/67 10M Signed ----------------------------------------------------------------- ......
..----
7537 Prospect Rd Mercury
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