18660 1912 Belknap Court
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING nand/or GAS/�PiIPING PERMIT
Date------D40.,-'t ------------------- 192 Permit No...._L.14. 0 ...J.............
The undersigne ere k�0 �
li n }ha ifi I r of the City of San Jose
for a permit to i tall an d ip lis�¢rse side.
Exemption fro rag am n C o is Contrac or'sLicense is hereby claimed
by undersigned: er ❑ statement filed
Undersigned attests that his State of California Contractor's License
is in full force and eect and properly authorizes this application.
San Jose
City B ess nse $k
I certify that Ih formanca ~-41pe is is ed•I shall not employ
any person in any ��y, as to vise ' n I s of California.
OWNER J_t �r 7 u -Yl dI l
ADDRESS �// Jq ( Lot No.
USE OF BUILDING 1,40
'Signed g .---- --' --
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1,912-\BELKNAP COURT ACE PLB.
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