37463$59 BETTE AVE PHONE: 277-4581
y Building Permit Confirm
- - Not Required ❑
CITY OF.SAN JOSE BUILDING DEPARTMENT
APPgLIIcATION FOR PLUMBING and/or GAS PIPING -
PERMIT
Date... ..: ......... ------ 19-77C Permit No. ,...1.....1- .. ...
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
for a permit fo install plumbing fixtures and/or pipes listed on the reverse side.
Exemption from requirement for Stale 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 authorizes'this application.
San Jose. City Business License # '
I cerlify,hat in the performance of the work for which this permit is issued I shall not employ
any person. �� ;.
OWNER CHR<f F YAW ti1CC1N1
ADDRESS. RSCt Lot No:
USE OF BUILDING 1s1r(I-1t 111, 11 1
Signed ........
280-401N
Q:� BETTE AVE OWNER
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