8179 6664 Clifford
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBIN and/or GAS PIPING PERMIT
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Date.----------------------------------.------ 19........ Permit No.......... /....-Zv/-�
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The undersigned here k s a 'ca ' n +he in Ins of +he f San Jose
for a permit +o install p m fi re / ipas ste f ev rse side.
Exemption from tequ o ate a {o on c s License is hereby claimed
by undersigned: as owner ❑ statement filed ElUndersigned attests that his S ate of California Contractor's License -. /Z 3 7 C 36
is in full force and effect and properly au i ori s f s applicafio o
San Jose City Business License
I certify that in the performance of fb work which this permit is issued I shAll not employ
any person in any manner so as to.violets 1ha workmen's compans.e ion laws of California.
OWNER L D
ADDRESS (7i Lot No.
USE OF BUILDING fZ C—S
20030 Signed C /�
6664 Clifford Ace
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