20369 755 MOLTZEN DR
Building Permit Confirmed
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date--------------¢//------------------------- 197K. Permit No<;2---�-- --�-- ......
The and ersignod re y makes a plication ty rhe PI Bing Inspector of the City of San Jose
for a permit to insf i ed on the reverse side.
Exemption from q re f ate of alio a for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that his St-{ of California Contractor's License # �7��3/
is in full force and effect and pro a orizes thi p c
p a ,TJX
Sen Jose City Business License
I certify that in the performance of the work for which 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 7-41i'tef-
ADDRESS 7rC�� MOl 7-7- �fe/dam Lot No. �¢
USE OF BUILDING S/D�t//TJ/,91�Ci(�_`--
280-30(9-73) Signed ....ColkGy[[ILCR-�j�.r-:Y�[C:-------
. 7551 MOLTZEN OR CENTRAL SERVICE '
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