32607 (2) 915 Tantau Ave /
Building Permit Confirmed 2--
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
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Date------------------------ -------- 19.E Permit No. . -----------------------
The undersigned hereby4*90
mbing Inspector of the City of San Jose
for a permit toinstall plumfgdt o�fjMi•� reverse side.
Exemption from requireor o ctor's License is hereby claimed
by undersigned: statement filed ❑
Undersigned attests that his State of California tractors License # /Q 0171
is in full force and effect and properly authorize,
this i ion.1//�/7V
San Jose City Business License # —cgs' I •r�sr/i�
I certify that in the performance of the work for which this permit is�issued I shell not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER CLIFT09C5 K/ NES
ADDRESS 9('9 TFINTAU AV - Lot No. /20
USE OF BUILDING PPtO POC7L
28030(9-13) Signed---ALI..T1cto./.>,/..i---..1.a0L:r------------------
C, D-Or¢eL/✓C
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