81775 (2) 6715 Clifford Dr g
CITY OF SAN JOSE BUILDING DEPARTMENT
s651-1
APPLICATION FOR GAS PERMIT
Date ---12-2?-71..................... 19.......... Permit No.....(�C..--l-. --.....
The undersigne e eby makes ap licafio to,the Ply bing Inspector of the City
of San Jose for p t I ap is c a gas pipes as listed on the
reverse side he a in ai p sand/or pipes in accordance
with the provisions of title VIII, Chapter 4, of the San Jose Municipal Code, and
other laws applicable thereto. Q
I certify that in the performance Of Vo fg�w s e iisnssued I
shall not employ any person in any m 6{� a �+ fkr�l5r(s tom-
' pensation laws of California-
OWNER--
alifornia"OWNER..Leo:R. Collins ..--.----------------------
ADDRESS.......6'1 5 Cl.iffodd..Dr... --- ... — ..... .._....... LOT NO.. .. ......
..!=-----....
USE OF BUILDING........... Rental - -- .................
Rental ............ .......... -
2e0-20 (Re, Apr. 691 Signed--------------------------------- ..kle_aLinp-Z`--ll2nLilati:
6715 Clifford Dr Atlas Htg & Vent
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