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78363 870`1ily Ave • l-, r� CITY OF SAN JOSE BUILDING DEPARTMENT APPLICATION FOR GAS PERMIT ��jj �`� 3 Date---.a .9.......... 19-70 Permit No....>�4? ........ The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose for a permit to install said appliances and/or gas pipes as listed on the reverse side hereof, and agrees to install said appliances and/or pipes in accordance with the provisions of Article VIII, Chapter 4, of the San Jose Municipal Code, and other laws applicable thereto. ' I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to violate the workmen's com- pensation laws of California. a t ,n \VI - D pp OWNER...... ... ......C..... ......_.. .:_... _.. - ---. ------ ------------ o.s Do !� l ,,(( m O ADDRESS........ .. - ..(.:..�.�'. .. ....../ �..U...tz ..., LOT NO.._.:c.n.v z USEOF BUILDING....... -.............-........ ........_...----- -....------- ------ 280-20 (R.v. -----280-201Rsv. Apr. 691 Signed........ ......(%k�..�. ......__-.....-_ ....... _..._-_�-m - 870 Li1V Ave , &M Heatinq a N T G a d d C d� � a a �• T � d S a � Q \O ^ yCL C O d C N N M �. D O O i m -y a o O m C u v a v N � o N• _ a O Z a \V 3 1 A a _ m v \ a � N S A A a a