13932 1132 Kenwood
Building Permit Confirmed ❑
q s
Not Required ❑
CITY OF SAN JOSE S R`6 BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date --------------------- 3 1 -
- 10 Permit No.-----' ?�(� 3 Z
......... - - -
The undersigned hereby m s p h ctor of the City of San Jose
(ora permit fo install plumbi / i r f reverse side.
Exemption from requirement for ate of ali(ornia for Connector's License is hereby claimed
by undersigned: as owner ❑ sfet'e�m"en# filed ❑*01*
Z
Undersigned d efts that his State
perl of Californi afros 2rF, e '
is in full force end effect and properly euahorizaz 4 is e icatio ..�� / 6
San Jose City Business License #
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 compensation laws of California.
OWNER LEN 1 17x
ADDRESS 2 �Ey&�Od Z) AV Lot No.
USE OF BUILDING KC-S
�J �cu�
280-30(9-73) Signed .�--�--.--��.L.r. .. - -.....----"------
1132 Kenwood ace
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