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21100 Building Permit Confirmed In—�' Not Required ❑ CITY OF SAN JOSE BUILDING DEPARTMENT APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT Date..........1::6— 2f---------------------------- 19:7.G- Permit No.-----.....Z41-e-�0................... The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose for a permit to instal u g if an r pi as st oyµ'a reverse side. Exemption from r i m for 5�31�e�alff� dM tor's License is hereby claimed by undersigned. � owner ❑ statement filed ❑ Undersigned attests that his St to of California Contractor's License # is in full force and affect and prop hori:es this a„py,I.,,ati n. San Jose City Business License Q- b SF// I certify that in the performance of the work for wkiA 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 T'✓CG03E LL. i2✓+�T" ADDRESS 7484 S �u Lot No.`► �d3'0 USE OF BUILDING- 280-30(9-73) UILDING 280-30(9-73) Signed ....... 7484 KINGSBURy pIACE CENTRAL SERVICE OW Q '^ 1I DC HsT p QHZEf ffo7_cr �+ W EEE m n" F - 3 A a 2. n. E O C N S v I 0 0 1 T + + T C o 3 ° �^ N N c o X N O n N O + y C q N A N a T = N N N m N a Z O T \� \ \a \a \a ,~m W D � W 9 ca9 T N Q E y 3 T H Z E N N 1 N 9 9 V A C 0 0 0 0 N O y N p N O N < N ° + ° N 3 � + 3 r y d O_ �] O_ ` d T , Z u a O o ` m a < N\ Ti D T , °N HO i D D `° A o T A ` Gl T o A o m A o Z V o N m �° N m ° D A N m c0 T y - 1 m D Z ' , D �� � ��� m I� Q