843626IW Ci-VA'IWMSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
362
Date..._N��e--Z-6- oJ�-----------195.......... Permit No__
The undersigned he eb r I p r + e I g Inspector of the City of
San Jose for a per m p ing r wipes listed on the reverse
side hereof, and agrees to install 'said fjyturee nd/o r e �j'^ g�ordfnn a with the
provisions of Article VIII, Chapter 2, o%jkb�ee(JI{faKC�dAi and all other
laws applicable
OWNER
ADDRESS
USE OF B
Form 780.30
7791 Lilac Way Monte Vista PLbg. co.
LEo
of