8178 6379 Atherwood
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date............ ..... - -y-- •>.... 197'. r 't N 1-7f---------
The undersign. her a i n to a In actor of the City of San Jose
fora permit to i }all u a d os isfa on a reverse side.
Exemption fro requueme for State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑ `�/ ;
' Undersigned attests that his Slate of California Contractor's License # 2,3 7 C-3
is in full force and effect and properly authorise this application. /
c _ nyr
San Jose City ierse
#I certify }hat in mance w rk r ri his if iz issued I shall no} employ
any person in a ns to .o t . rkmen'U001-Is a}ion laws of California.
OWNE sT -!✓S-6•V' H,
ADDRESS 6 ,37 ? 4 T{l6k cc rOO D AV Lot No.
USE OF BUILDING �S
�� .���=.. ------------------
6379
280 30 Signed Clc,c.. --- . .. . - - � - "--' -..._.....
6379 Atherwood Ace
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