77703 (2) 853 Lonna Lane
CITY OF SAN JOSE BUILDING DEPARTMENT ;
7l
APPLICATION FOR GAS PERMIT
Date...... .�.� .----------- 19--- Permit No.2.L..IT_77.,z)....
The undersigned hereby makes application to the Plumbin nspector o ify
of San Jose for a permit to install said appliances and/or 9 is on the
reverse side hereof, and agrees to install said applia o p' ac rdance
with the provisions o Article VIII, Chapter a San os uni 'pa ode, and
other laws applic thereto.
I certify that in t per or nce he o for 'ch this permit is issued I
shall not'emplo any Pers i an a o violate the workmen's com-
pensation laws f Califor
OWNER .-- .LO.... ......... . _.. ......... t�
/ 5....................----------------
............. LOT NO. - ......ADDRESS ' 3... � .... .. ... ...
..
USE OF BUILD ING........... �"`�.... ' ......
280-20 (Rev. Apr. 69) Signed._. '= - "- -
853 T,PRRd
;.an-e 1 BPiinff Atlas Heating`
.ate. m Z 1D o T y T ` G1 m a m o m a
c
CL
0- CL^ ' ac o � c�• a a o.
D 0 m 0 n < 0 m a N O ° n 2 N
m D D 0 m n a v
a D
N a
CL .
N \ _
O
V a
� m
V �
d n
n
� m a
n
A
a
m