27110 (2) 1033 TUSCANY PL
Building Permit Confirmed$
G Not Required ❑
CITY OF SAN JOSEI/ BUILDING DEPARTMENT .
APPLICATION/FOR PLUMBING and/or GAS PIPING PERMIT
Date......`r�./.-I-- `i'---7-�------------ 19........ Permit No.—.2.1WO
undersigned hereb makes application to the Plumbing Inspector of the City of San Jose
for a permit }o ins}all p fi a r ✓ ' } the rove"* side.
Exemption from req ' r o Ii o ontrac}or's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that his State of Californi o ctq� Ipf.�
is in full force and effect and properly authorizes p liot O f �^
San Jose City Business License # `J J -
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 , •1=���
5 3 TJ S �tQ L Lot No.
ADDRESS e
USE OF BUILDING 1 0 C-L&T—^A "I L'/
V�� �.....(--------------
���L Signed......I- �tl- ✓' -
1033 TUSCANY PL T & F
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