29762 1075 MILKY WAY
Building Permit Confirmed
Not Required Cr
CITY OF SAN JOSE / BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
`` 77 ��
Date..........)01 _................ 19... Permit No....:../�..J... - .... --
The undersigned reb makes tto y PI m ' Inspector of the City of San Jose
for a permit to instaaaaaaBBBBBB pl or s t n the reverse side.
Exemption from requ mon or Staf of ali rnie or Contractor's License is hereby claimed
by undersigned: as ownrri
statemenf filed 11 _ � /J
Undersigned attests that his St C Mr. for
's-License #' �"L 77�Z 6�
is in full force and'effecf and pro er s p c ion C
San Jose City Business License
1 certify that in he performance of the work for which this permit is issued I shall not employ
any person in any a ner so as to violatethe}he workmen's compensation laws of California.
OWNER 1 Wl t
ADDRESS 075 Lot No.
USE OF BUILDING
� Signed.. ... .. . -- ' --- �----- ---..�. �_�....
2 Ot4oln
1075 MILKY WAY OWNER
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