14860 26639 Cleo Ave.
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATTIO¢¢N FOR PLUMBINyGf and/or GAS PIPING PERMIT
De#e. "_o`..:.SJ........ - ...... 19.L-b Permit No.-----4?!� .----------------
The undersigned h eby make ph tion t the Plumbing or of the City of San Jose
for a permit to ins r in t pi sIe o r versa side.
Exemption fro r w or f pr ' o or's License is hereby claimed
by undersigned: es owner statement filed ❑
Undersigned attests that his S e of California Contractor's License #'
is in full force end effect and pro lyrizan.I f-�;'`
San Jose
City Business Lice a / �)"—/�/
I certify that in the performance the work for which this par iss�issued 1 shell not employ
any person in any gmanner so as to violate the workmen's compensation laws of California.
OWNER /A�i�LTE/P cS/LYA ( C/`�f1P%//Z/d
/f'/9/L/NjU H� 3�7�`�-0 Lo# No.
ADDRESS RQ,4 av�-� C LL'o A PZ cS'i
USE OF BUILDING /l ,A'Sl10 W1 �~
280-30(9-13) Signed -. - - -- - -- - --.
20638 Cleo Ave. oP -
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