35137 1220 YORKSHIRE 'DR —/
4 Building Permit Confirmed
Not Required 0
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS gPIPING PERMIT
Date_--------------------- ------ 19........ Permit No--------7-i�3.7 ................
The undersignedhereby makes application to the Plumbing Inspector of the City of San Jose
for a permit to ins}all plumbing fixtures and/or pipes listed on the reverse side.
Exemption from require nt for State of California for Contra .is License is hereby claimed
by undersigned:- s ov net ����£}arnent filed ❑
Undersigned attests th t h"Stale of Califo/rdie Contractor s L¢ense #
is in full force and effect and properly authorizes this application. f�
San Jose City Business License # L���
1 certify that in the performance of the work for which this pe�issued I shell not emp oy
any person in any manner so as to violate the
work/men's compensation laws of California.
OWNER —T—a_, /r LA
ADDRESS IZZOhrgsllgVeDn, Ca, Iylb Lot No.
USE OF BUILDING V lW en
/ Signed _._...---" '- - - --'-~.-"-----.....-----
1220 YORKSHIRE OR
OWNER 280-401n
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