28194 7520 DELA FARGE
• A f Building Permit Confirmed ❑
`SII Not Required ❑
CITY OF SAN JOSE ✓ BUILDING DEPARTMENT
'APPLICATIO��N FOR PLUMBING and/or GAS PIPING PERMIT
Date....----4�1..... .. .......... 1917- Permit No...:.�2-_�!.-9_�/............
The undersigned hereby makes applicalio��to f PJumbin pector of the City of San Jose
for a permit to install ii /or pe Tjs�e�e reymse side. `
Exemption from re o ifo r trector s License is hereby claimed
by undersigned: as owner statement filed ��
Undersigned attests that-his State of ifor is Conor cfor's License #
is in full force and effect and properly au or is ep cei h �
San Jose City Business License # /`Q`(
I certify that in the performance of fha work for which this permit is iisueZ I shall not employ
any person in any manner so as to riolafe the workman's compensation laws of California.
OWNER 514- L w0 4 M 3
ADDRESS 750.0 DF— /-4 LotNo.
. . 1w
USE OF BUILDING �gnNL6r.,
. r.--------------e
280-401n
7520 DELA FARGE SIERRA , ,
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