NO PERMIT NUMBER (3) 884 Rose Blossom Drive
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR GAS PERMIT
2� IxT
Date------_.. ._....................
........ 19....70 Permit No------------------- ------------------
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The undersigned here a a I' h tubing Inspector of the City
of San Jose for a per rt a aor gas pipes as listed on the
reverse side hereof, an re s to install said appliances and/or pipes in accordance
with the provisions of Article VIII, Chapter 4, of e n J�[e,��'}uniciF�-Co e, and
other laws applicable thereto. de /►!�1/OI
certify that in the performance of the w f r wh c t is per i issued I
shall not employ any person in any manner so as to violate the workmen's com-
pensation laws of California.
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OWNER------— ...... ---------------- .... ........... .. .. .. ..................
4SSLE -- -- -
ADDRESS....-- --------- ----- ........------- ... LOT NO.
USEOF BUILDING._. .........__...... ...........__.................--- -...--- ---------- --- ...-----......
280-20 (Rev. Apr. 691 . Signed ... _...--- _...........___......_- -
884 Rose Blossom Drive Yorke
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