41663 X33 AtTEi3 LANE
Building Parmi} Confirmed
Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date................. ------.------------- 197y Permit No----------- .`--"`- /--'-----------
The undersigned hereby makes application 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 �{' C
is in full force and effect and properly author' s this applJ'c�ef�in.
San Jose City Business License # i�A� y
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. C •r
OWNER 2,,C�
ADDRESS Lot No.
USE OF BUILDING
Signed _ _ /�`-- ...................--------
80-? Oln
1333 ASTER LANE �j�" BIIL S PLBG
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