104387502 Fallenleaf Lane
CITY OF SAN JOSE
Building Permit Confirmed
Not Required 9
BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date - ---7---3--c-)-------_
- 7. 3--------- 19.79. Permit No. .......
�..7 -3 .................
The undersigned hereby ekes application to the Plumbing In ecfor of the City of San Jose
fora permit #o install pl x# a / i i d reverse side.
Exemption from req a Sh or a F ractor's License is hereby claimed
by undersigned: owner ❑ statement filed ❑ 2 37 C3(
Undersigned attests that his State of Calif is Contractor's License #
is in full force and effect and properly author' rs app' fi A� u 6
San Jose City Business License #' ,!—`J"f r
I certify that in the performance of the work for which this permit is i sued I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER 2wye - , 9,
ADDRESS 7 SU Z FALLEN LEr1 n
F L/ Lot No.
USE OF BUILDING \ S
280.30 I Signed.C.4�4...V..['o�Go'...... .
7502 Fallenleaf Lane Ace
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