32305 ..7921 Belknap Dr. Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
for a permit t gi s} p m in ,irfure /or s listed�r,0... --- �.
�.�.....-......
Date........... P
The undery n he PI a of the Cif of San Jose
osa
d on the reverse side.
Exemption from requirem t for State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attest that his State of California Contractor's License #' 2
is in full force and eff f and properly aufhorj�e th' pp 'a '
San Jose City Bu nes a # —t
-
I certify that in he or once of e o for which this Pero for which this permi i ed I shall not employ
any person in any ne s to violate the workmen's compensation laws of California.
OWNER
ADDRESS ?ilC Q Lot No.
USE OF BUILDING
Sig�ed
7921 Belknap Dr.
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