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LL47 Kentwood Ave.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR GAS PERMIT
Date -------- _-/A.1.--.. -0�.._.. 19..ro...... Permit No.------ `f'7
i....y
The undersigned ereby makes application to the Plum binq J nspector of the City
of San Jose for a permit to 'n ce n r apes as listed on the
reverse side hereof, and ag a is n or pipes in accordance
with the provisions of Article VIII, hapter 4, of the $an Jose un cipal Code, and
other laws applicable thereto. �j--� �} is
certify that in the performance of a ork f r ich isV13er/mit is issued I
shall not employ any person in any manner so as to violate the workmen's com-
pensation laws of California}{.
OWNER . �^/G2 2t -�%-
ADDRESS - /
1411
USE OF BUILDING
- ..... -------
FORM 280-20 4/67 IOM Signed ...._.._........._--- .---------
1147
_.LL 7 Kentwood Ave. S. Rafter