29506 7647 ELDERWOOD CT
l A Building Permit Confirmed""
No} Required ❑
CITY OF .SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date........2...-.. --------------- 19.Z.T Permit No.---'---...--....-----�S®P---
The undersigned here makes application to the Plumbing Inspector of the City of San Jose
for a permit to ins}all u1� ?e d i ed on the reverse side.
Exemption from th rNf� or Xafr/ for Contractor's License is hereby claimed
by undersigned as owner ❑ statement filed ❑
Undersigned attests that his Sfe}a of y,�y�„�` rtia C�yy��y� r/j�cc
is in full force and effect and properly au[k6r��fhis'ap i i�n!�
San Jose City Business License # J-I-7 - O L D L 4'
I certify that in the performance of the work for which this permit is issued I shall not employ
any person in any manner so as to +folate the workmen's compensation laws of California.
OWNER DAVIL Zo 'g le.I eLq
ADDRESS 7 1�, aRw04N C-r Lot No. IcA
USE OF BUILDING ^^q-/�
280-30(9-13)
Signed .....r.JJ�n/racv----.Q. .-----------------
gooL.
7647 ELDERWOOD CT
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