78118 6657 Clifford Drive
CITY OF SAN JOSE BUILDING DEPARTMENT
S 3 7 -6APPLICATIONFOR GAS PERMIT
Date... 7//?
...................-......... 19..�� Permit No.--------- ----_..../.........------
The undersigns h reb m/ k ap cgfi n he Plumbing Inspector of the City
of San Jose 4 m es and/or gas pipes as listed on the
reverse side h o an agrees to install sai appliances and/or pipes in accordance
with the provisions of Article VIII, apty4, of he San Jo Municipal Code, and
other laws applicable thereto. w � �6�/ '
-� I certify that in the performan theor wh is permit is issued I
shall not employ any person in any manner so as to violate the workmen's com-
pensation laws California.
OWNER.....----...
ADDRESS CI�Y'..�. 2/. / a..G --- LOT NO.......-------
USE OF BUILDING....
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280-20IRBV. Apr. 691 Signed.`
6657 Clifford Drive Selloff, At, is Heatir
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