24109 (2) Building Permit Confirme_d,[��
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or
No... �..and/or GAS PIPING PERMIT
Date -- .._ 19
[? J � _ .:1.
. �- �.. -- � ---
The undersigned hereby makes application to the Plumbing Inspector of fhe City of San Jose
for a permit to install plum 'store / r e ed n erre side.
Exemption from require a a' i n c or's License is h re y laim
by undersigned: as caner ❑ +" ' statement filed ❑
p j.
Undersigned attests that:his„State:of California?Con4acfor's License #
is in full force and effect andproperly authorizes„f "catio
' .. �,. �.`n�....
San Jose City Business License>'#,m'
I certify that in } orma-1 1nc_e"of'the work/forwhich this permit is issued I shall no employ
any person in any mann"? is to Ylole+e�}he workmen's co p sa}ion laws of California.
?
-OWNER
ADDRESS O % Lot No.
USE OF BUILDING _J nic
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280-30 (9-73) Signed ..- P.V.Yf-1/=.=..j-------. ... ..................
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