19341 7373 Fallen Leaf Lane
(JI] Building Permit Confirmed
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
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Date..JF}NUfYCY-------zn----/---- 1976,.. Permit No-----------------/.......---------�.----.
The undersigned here y makes application to the Plum g nspector of the City of San Jose
for a permit to install u / r/'/ or �i �J �orf the reverse side.
Exemption from re i //or She'e o alifornia for Contrador'z license is hereby claimed
by undersigned: as owner ❑ h s}pt a tt fit6d
Undersigned attests that his State of OJ rola n r;.tT9rr
is in full force and effect and properly aaAhorSthis application.
San Jose City Business License # I7 , '/L'�7 3 i
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 lE2olotiG K �1tcl5/GL SArlfl/zfl .SF}NOS f1A'J��lst6�l5.
ADDRESS 7 3 7 5 Ffk -67,J L EIRP. 'GFI NE Lot No.. �P
USE OF BUILDING �}12TYvLC��
280-30 (9-73) Signed..G <L . . .... ... ..........
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7373 Fallen Leaf Lane CS;a'lv_a_to�,Orlando
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