6209 (2) 7675 Erin Way I
"I Building Permit Confirmed,]'
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
/ �
Da#e-----------11-�---....-�----------------------- 19.._.... Permi# No.---------------L7..<..=U------....--.---
The undersigned hereb�r.•rnakes ep lic }ion � the Plumbing Inspector of the City of San Jose
fora permit to ins}all /Irmb/-���'A((('y fi r an a li ad- a reverse side.
Exemption from regpJrreln'£nW 5} f I' o i� actor's License is hereby claimed
by undersigned: s own statement filed ❑
Undersigned attests that his oStatepen o (orpia Coplra s L se
is in full force and affect and properly au i s•4hiss p a
San Jose City Business License #
I certify that in the.performance of the work for which this permit is issued I shall not employ
any person in anymannerso as to violate the workmen's compensation laws of California.
OWNER I hOrvWKS 4 •
ADDRESS 105' e:y-( Lot No.
USE OF BUILDINGf ' Q
280 30 ` Si9ned. .L.GG<.C.�.. ..... %.��:C..._------.......
7675 Erin Way ✓J Ebert
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