13956 (2) 9546 nefoe nr. p
IBuilding Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date----------------------- ------
---./O- 197 Permit No. ...............................................
The and ersignod ah raby ekes epplice}i to 4he in I or of the City of Sen Jose
fora permit }o install plu i } s a / ip is d n e averse side.
Exemption from requi a aie a ria or Con}rector's License is hereby claimed
by undersigned: as owner stateme t filed C) /
Undersigned attests that his State of i Cori s 1 ns C
is in full force and effect and properly e r e� is r � j
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 CEA/'rLI�'y n CO/✓ST_
ADDRESS 75 y6 CIE Fob OR/Va Lot No.
USE OF BUILDING A/ yoo NT A L
230.30(8-73) Signed ....... ..........
.............
7546 DeFoe Dr.
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