80848 (2) 862 E. Estates
CITY OF SAN JOSEBUILDING DEPARTMENT
APPLICATION FOR GAS PERMIT
Date------- ------------............. 19. L.. Permit No....... -- o j-yK
...................
The undersigned hereby makes application to-the Plumbing Inspector of the City
of San Jose fora pe!,rR �hf
a r gas pipes as listed on the
reverse side hereof, 5mB a, a es and/or pipes in accordance
with the provisions of Articf the an Jose M nicxipal Code, and
other laws applicable thereto. e� �/ic I m.
I certify that in the perform anc a work for w is er it is issued I
shall not employ any person in any manner so as to violate the workmen's com-
pensation laws of California.
OWNER.... i1I`�ES - �.N-. ... ................
ADDRESS 2L,72 -....<e�......E_>27W...TZT,S'._41/;. ...... LOT NO--------------
USE OF BUILDING..C-y. AzA—..JC�..E_.------RC/L/yCSDGC IIVG.................
280-20 (Rev. Apr. 691 Signed._.1..)AIIIZ . -------119L1J -f~ -------------------_---
862 East Estates ��" ��H nsen
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