6662 7928 Woodlark
Building Permit Confirmed ❑
Not Required —tf---
CITY OF SAN JOSE BUILDING DEPARTMENT
- APPLICATION FOR PLUMBI G and/or GAS PIPING PERMIT
Date-------------------.---/.. -- --C�-- -..... 19.]j. Permit No.----------------zz'o/ ---------
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
for a permit to install plumbing fixtures and/or pipes listed on the reverse side.
.. Exemption from requirement for State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ ' statement filed
Undersigned attests that his eof California Contractor's License ' ;ZIP/-z
i is in full force and effect.end properly aurh�xes iC/ appli�%�rw�(
San Jose City Business License #' off S
I certify that in the performance of the work for which 01 perm ii is issued I }hell not employ
any person in any manner so as to violate the workmen's cc law Ialift^California.
OWNER 022&-/'?' ,e • lL/ Y y W
ADDRESS 7026' 1-60101-If/Z tyy Lot No.
USE OF BUILDING tics �}
Signed au'..-�-1� _ y ,(( ------------------------------
280-30
7928 Woodlark Ace
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