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Building Permit Confirmed
Not Required 10
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date..------------------------------U. .. Ll.. 19.7 Permit No t ------------------
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
for a permit to install plumbing�iisfures an or iPe I's n 4h rse side. '
Exemption from requireme ( a { r ra r s License is hereby claimed
by undersigned: as o r sfatement filed ❑X66998
Undersigned atfests that his Sfa4 of California Co racfors License/# r�0 /
is in full force and effect and properly authorizes fhis pp /tion.
San Jose City Business License # b
I certify that in the performance of the work for which this permit is issued I sfiall not employ
any person in any mannersoas 4o violate the workmen's compensation laws of California.
OWNER / eY 5-
�IOM�S
ADDRESS ' `/— ( Lot No.
USE OF BUILDING
Signed
280-30(9-73) \� / '� GE I/... O.'-4----- ..................
ned .......LOIAI -.. -
,1051, TUSCANY PL CROWLEY
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