38630 AST2>2 LAM
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
-3-?(a-S J
------ -.__....._....-----. 19.'.. Permit No.-------- - ----.-----...
The undersigned hereby makes applicafion 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 State of California Contractor's License
is in full force and effect and properly author izfs�4 s ep i t,
San Jose City Business License # `! P—7V��e_
I certify that in the performance of the work for which this permit is issued I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER
ADDRESS Lot No.
USE OF BUILDING /
Signed
1259 ASTER LANE ACE PLEIG.
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