31557 (2) 1554 PRIMROSE WAY
Building Permit Confirmed ❑
C/ Not Required ❑
CITY OF SAN JOSE I BUILDING DEPARTMENT
APPL19ATION FOR PLUMBING and/or GAS PIPING PERMIT
Date-------.. .---- ------------- ...1---------------- 19.?� Permit No.-------- .x... .....5....2..... ...........
The undersigned hereby..makes application to the Plumbing Inspector.,of the City of San Jose
for a permit to install plumbin fix urea d,.%��o,,��` li}�odf f!� ae side.
Exemption from requirementifo. Staten C.1ifornla it�Con frecfors License is hereby claimed
by undersigned: ai owner ❑ �+ sfatamen} {filed
Undersigned attests that his State of C.allfernlaI Contra.tor s Aconse
is in full force and effect and properly authorizes fhii application
Sen Jose City Business License #
1 certify that in the performance of the work or whic this permit is issued I shall notemploy
any person in any mann so as to violate the workmen's compensation laws of California.
OWNER
ADDRESS S S L Lot No.
USE OF BUILDING A--
Si ed----- . . - - . ``.---"- 1-1 x.10-2
1
80,401n
1554 PRIMROSE WAY S� `' ' '�` ACE P_ G
c o 0 E 1 o D C o S T O O to o 0 0 ox r, T W E E
a � o — =, n -• p p p p
F s m m
N N N N
N
C T
o/ m
m
W D W a W 9 W 9 gr>
3 T �/! Z E�.oo m Z
CD Ep Hi DANm A�nA � Ow pim
y mA " C 3 >