32032 7464 FALLENLEAF LN
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date..------ - - �1� ... . ............. I 9.. Permit No.. S ZO 2
. ?- ... ----- . ............
The under igned hereby makes application to the plumbing,ingector of the City of San Jose
fore permit fo install lum fJ''',f s esd/ a reverse side.
Exemption from raquireo Stat aP ornie f� onfrector's License is hereby claimed
by undersigned: �{ owne statement ailed ❑ ��
Undersigned attests that his State of a na s en
is in full force and effect and properly au rxo�I O�
San Jose City Business License
I certify that in the performance of the which this permit is issued I shall not employ
any person many manner as to violate the workmen's compensation laws of California.
OWNER
ADDRESS Lot No.
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USE OF BUILDING
Signe611
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