14929 2696 Cleo
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS /PIPING PERMIT
Date_------------------i ----3D-----.- - 19..7 ermit No /- - >/ -----------...-
The undersigned b make p icaf' n to the,Plu Inspector of the City of San Jose
for a Perm to ins I pl /o p. d the reverse'side.
Exemption fro or e a rn Contreclor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests }ha} is S}ate of California Contractor's License
is in full force and e{fec} e r perly author.. hi p 1' ati n�
San Jose City Business is se #—
I certify that in the p o ce of the for which }his permi! is issued I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER ��R
ADDRESS Lot No.
USE OF BUILDING
280-30 (9-73) Signed --- --- -- -- --
20596 Cleo Apache Underground
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