21100 7522 KINGSPIURY PLACE
Building Permit Confirmed
-
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date---......`S'4----------------------------- 191.6.. Permit No......... ......................
The undersigned her y makes epplica4ion t the Plum ing Inspector of the City of San Jose
fore permit }o stall
la u e pi 41 onerso side.
Exemption from re firemen 54 a nie e r z License is hereby claimed
by undersigned: as owner ❑ s}e amen} filed ❑
Undersigned attests that his State of C fornia Contractor's License # 7/`-1 /—s
is in full force and affect and properly auth ri a ye
s p '
San Jose City Business License # /�-
0
I certify that in the performance of the ..rT for which this permit is issued I shall not employ
any person in any mannor so as to violate the workmen's compensation laws of California.
OWNER 1`2trU�L)L
72tic-T ADDRESS -7r IC JA4 qg Qad"t Lo} No. -3
548
USE OF BUILDING
280-30(9-73) Signed ....
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7522CINGSBURY PLACE CENTRAL SERVICE
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