33489 965 NMMSE!P -
Building Permit Confirmed ❑�^
Not Required K
CITY OF SAN_ JOSE -BUILDING DEPARTMENT
APPLICATIONL
FOR PUMBING and/or GAS PIPING PERMIT
Date:j/.. -_--p............................--`---- 19--> Permit No.-----s,/..,1. t7. ........----------
The undersigned h by/�a s �s efto� } ,ath Plu in Insp c}or o e City of Sen Jose
for a permit fo instal'j'8rspl�urir6' o s d r prp s lis o } /AroYBf eJ ide.
Exemption from r�put a en jjoo''fS alNo tC�i.B�ie orEf&'sb�icensa is hereby claimed
by undersigned: (bs owner ❑ statement filed ❑ i
Undersigned d attests that his Stara of 93rizes0th Contractor's License #
- is in full {arca and affect and properly aur oriza6fhti epplicep}ion. �(A'�
San Jose City Business License # Kt o-
1 certify that in the performance of the wo�r which fh"spermit is issued}employ
any person in any manner so as to violate the workmen's compensation laws of California.
-OWNER 7 PrsBS i? /I-W
ADDRESS .& S' A ,1,-_19h'EfLot No.
USE OF BUILDING
� L
Signed ..../�/-,r,/p.._..s'�la/s?+1 ..
m28o-401n
965, NOVEMBER FIVE STAR PLUMBING.
WOj N -4 E D C NSTOpN E E E E 0,2. 0
7CrNWEE
d O Jr O S S O O E S 2 rE
O S
N
Z
O
T
m
m
W D W D W D "• W D TN 0EN ; T �Z EN -4
a a a
c N cM� N O O
T d •� e m T g ' N 'o �. T �� p x E Z N n m c D E
O
N = D ;
Ta TN m mm � mT3 -4 m ; D
m
'" o C'1 T p A o o M m o Z
N T N '" m A D A ry N rD A O R p
TI
•� m m H O 'D
� m