9819 960 November drive
Building Permit Confirmed [�]/
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date T.1, �- I w. Permit No....._.�4 L0------------------------
y- n y
Tha undars ed hereb�� eY appli io Flo e/ I ing Ins�c}9ihe City of San Jose
for permit to install plumbing ff�tures andr/or P. li}ed onA a rare se side.
Exemption from requirement for State of California for Contractor's License is hereby claimed
by undersigned: as owner A statement filed ,
Undersigned attests that his State of -44,19;9rw Lee,
Ceityorr�r�i U�fract s Li�ns
is in full force and effect and properly author £"t�/Sppli iion1 —
San Jose City Business License #
I certify that in i performance'pf th war for which i rmif is issued I shell not employ 3 '
any person in any me er so as sl�Vjblate } a orkmen:s co n e}ion laws of California.
OWNER
fix
ADDRESS Lot No. 6y
USE OF BUILDING �K 1 k
280-30(9-73) Signed/ ti.--- .. .. .. ..... ..........
960, November drive hassivlberm:
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