163427445 Plum Blossom Drive /
1 Building Permit Confirmed Cal
Not Required ❑
CITY OF SAN ,JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS/ PIPING PERMIT
Date --- �-------..4---- -------------------------- 19-.1. Permit No...-l---[lG.-- -- � -------------
The undersigned hereby m s�applicefion j lhalumbi Inzpec}o the City of Sen Jose
for a perms} io ins{all plumbs g }r fGs /d'r� ,�'PP9�'list�r side.
Exemption from requireml&nf^'foffz to
o Cq(fforma fpr L'onffao}ofw� icense is hereby claimed
by undersigned: as ner ❑ statement filad ❑
Undersigned attests that his State of.California Contractor's License
is in full force and effect and properly authorizes this a l� ?PTX
a.i
San Jose City Business License # ?PTX6P/7 N IV B
I certify that in the performance of the work for whieh this permit is issued I shall no{ employ
any person in any menper so as to violate the workmen's compensation laws of California.
OWNER Y�//)�
ADDRESS
USE OF BUILDING
280-30 (9-73)
Signed
74.45 Plum Blossom Drive
Lot No. /
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