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41191 $01 MYYY,EIi AVENUE 16i� Building Permit Confirmed Not Required ❑ CITY OF SAN JOSE BUILDING DEPARTMENT APPLI ATIO FOR PLUMBING and/or GAS PIPING PERMIT .J q Date-- --��.. ........._._._.................. 19� Permit No.-----......y�l/-.�.......-------- T a under gned hereby makes application to the Plumbing Inspector of the City of Sen Jose for a permit to install plumbing fixtures and/or ' s listed on the reverso side. Exemption from re uirement for State of Calif rnie or Contractor cense is claimed by undersigned: as ow er ❑ fa}em n fi d / d ig ests that rs o alifornia ont'a r' Lice a (O i in f f of an p po orixes }hi pplication. ose�tysines License # -O' �{ b I c ify that in th performance of the work for which this permit is issued I shall not employ any pers n in any me ner so as to violate the workmen's compensation laws of California. OWNER ADDRESS ej Lot No. USE OF BUILDING Signed- -. ..yTw•. �t.. ... �, --,il ....- 280-401n 801 MILLER AVENUE FOOTHILL PLBG. D n XX N !1 R N N C N ti ^ N N Il + A m S r N N m N Z O ` w T AT m rl W D W D WD co > TH G'1FN 3 T �!' Z Fin 1v� � v+ a a a a a a a m C O O p O K H O m N p H p H D m 0T N D °. T H O K F Z �' ►� c m '^ CI � � mD D � p D T � -m TN m 3m r m m T m >n y ;-mu, m p m Z m " m m m