13588 1203 Belknap ct
Building Permit Confirms
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
-MbIITT
Date ---------------- I97S . Permit No..- .13�- �
-- -----
The undersigned ke li io pha.P rbing nsp c r of the City of San Jose
for a permit }o all n �xf n e 4 d i ev se side.
Exemption fr eq re or f Ca is or Co rac or's License is hereby claimed
by undersigned: as owner ❑ statement filed 9
Undersigned attests that his Strafe of California Confrac}or's License # GIS X
is in full force and effec and properly authorizes this�a, plication.
San Jose City Busin Lic # 1
I certify that in f er r ante of orl { 41 s 1 is issued I shall not employ
any person in any m n er s6-4s to violate the workmen's co pe a4ion laws of California.
OWNER
ADDRESS 2/% / K.G 1/ e f Lot No.
USE OF BUILDING ✓-�/ \
280-30(9-73) Signed ------ .-- :G---..- `-0N ----
1203 Belknap rose extern
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