Loading...
77120 (2) 6721 John Drive CITY OF SAN JOSE 1 BUILDING DEPARTMENT ,J APPLICATION FOR GAS PERMIT Date...`f'--1-/d. ----------- ------- 19 70 Permit No----..�/..................... The undersigned here makes ap licat n t the�P�Iyj��g Inspector of the City of San Jose for a per it li c �� as pipes as listed on the reverse side hereof, agr s to st II sae app ianc s an, pipes in accordance otherthe provisions le there VIII, Ch yof the San ose Myn al Code, and other laws applicable thereto. ttt999...�EEEi ��/jI' ('/j�/41}{G' I certify that in the performance wo for w i i permit is issued I shall not employgy person in any manner so as to violate the workmen's com- pensation la�wssoo ,California. OWNER...I ./c h /— /�.-- -/ ..`7. GL S__.._..................----...---- ADDRESS._.1o/..Z.2.�...0 ..��`/.5/.. �J.--- .r LOT NO.....---------- USE OF .......... 280-201 Rev. Apr. 691 Signed..... r,'7?1 .Tn1,, n ;.,o De Geus Type of Appliance No. Remarks (Check V) New Replace Relocate Gas Ranges Wall Heaters Gas Plates Circulating Heafers 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 -Z TOTAL 3® FEE Inspected and Approved By HOUSE GAS PIPING Number of OuflefsI I Size of Main FEE 1771 Tested and Approved By