5604 s92 East Estates Drive
/ Building Permit Confirmed ❑—
Not Required .�
-CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
�6o 1
Date---' .. L�—------------- ---------- 19..1 Permit No._...................
..... - - ------------._.. .......
The undersigned hereby.me as ap licefion !o fIJyP.lufn bin ,In to
of the City of Sen Jose
for a permit }o ins+all pl fG' i pi s J'd : f e reverse side.
Exemption from req Ste f Ca rn a or rector's License is hereby claimed
by undersigned: as owner statement filed ❑
Undersigned attests that his State of Californ ontractor's License
is in full force and effect and properly authorize i ' epplicatio
San Jose City Business License # /
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 violate the workmen's compensation laws of California.
OWNER �( / 7
ADDRESS t5gy , 4Cs,_ Y S ,� 5. Lo+ No.
USE OF BUILDING
aeo-ao
892 East Estates Drive Brown
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