71281 (2) 1123 Ko-ntwood
CITY OF SAN JOSE / BUILDING DEPARTMENT
APPLICATION FOR GAS PERMIT �j
Date Iz -..A-7 ------ -------------- 191i Permit No.----1--vaV....._._J-�
The undersigned hereby ak s ti t .P m ei �spector of the City
of San Jose for a permi 1 $4ee ;';P . r bas pipes as listed on the
reverse side hereof, an agrees o install said appliances and/or pipes in accordance
with the provisions ofle Article VIII, Ch/ e of tie San os ,Municipal Code, and
other laws applicable thereto. ll/6{> '�7/ ��Ju/ �(,`r1
I certify that in the performance t wor or, which this pe mid is issued
shall not employ any person in any manner so as to violate the workmen's com-
pensation laws of California.
OWNER --------------7i �R.....................- - _ -
-----......---- ---. -------- --------------
/ - �1 . /J
ADDRESS l..l Z ----- L�--��w?Ctl[2T� -.-..--C:w .......................
USE OF BUILDING ......lC/�.5...--/. ./....... ..................................................
.
FORM 280-20 4/67 10M Signed -- ... - / F--j'
.......... ... -----------------....."-. "-.... ------..--......-----..........
1123 Kentwood ! / C/ $ails
T' Z v � 02SD ?' c G1G1m Imm � G1 � G)
io m 3 m 3 ° m o ° E 0 d
a ' d 3 °' ° 3 , c — A
CL md A d 4 d Td� N a � T a Vi = a
o to
D O ° T y d n ^ C 3 .m O w a
'o O m v m O l
v
N
1 � O
a W f
3
r a
a �
^ S
a d
d
°