41290' 939 BUBB RD nn
Building Permit Confirmed I�l-
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOppR�� PLUMBING] and/or GAS PIPING PERMIT
Date----..3. -----....._.G.o............_. 19 /. Permit No.--- ---.°--..�-v----------------
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 F statement filed E] -
Undersigned attests that his State of al ifornia Contractor's License #
is in full force and effect and properly authorizes this application.
San Jose City Business License #
I certify that in }he performance of the work for which this permit is issued I shall not emp oy
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER J •• j'I !C/'LC //
ADDRESS 7 / eU ala Q1) • .. Lot No.
USE OF BUILDING SIA/ IS ��' -S/�sadcAL
Signe .- --- - --- - -- -- x --------------------
26o-461n
939 BUBB ,RD OWNER
�^ WO _ N1F C N2T_ GpNFF FFO 7CrN W F F
p
_ n o � avo � Fm sSN oE �- AA
00 1
O O O O. 7 N N O' T ] O N N N N N S N O
N N y 0 C
� A R 7 Ill S NO N N N m
N
\ Z
\ O
\ N1 I m
ae D W D ca > W D TN LlF _N ;
9 9 9 O O< 0 0 0 . O. % H O O H O H A O N.
N m
C Z
0 o m 0 o 0 0 F
A r O rt T O T O A m O m 2 p Z
A I of cl O I \ O 3