24363 9WOLDTOWN CT
(/J Building PaConfirmed ❑
/ Not Requireedd
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date---- .).0. .. �. 7 ----L 7.�'L�.--�-------------
�---- --- -...... ..._..--------
19. . Permit No.
The undersigned hereby ap h efion t he P bjpg Ins actor of the City of San Jose
fora permit to install plurpbi�, i �/ a lis d n' verse side.
Exemption from requireamoni,,//gga+o efo 0 h �a n c or's License is hereby claimed
/ii�
by undersigned: a owner statement filed ❑
Undersigned attests that his State of Ce q(ni Contractor's License #
is in full force and effect and properly aufh�rix S 's applic ' n./��
San Jose City Business License #
I certify that in the performance of the work for whic this permit is issuecVl shall not employ
any parson in any manner so as to violate the workmen's compensation laws of California.
OWNER SfIM�S ('` F7/I 1 E1ZrD✓
ADDRESS ,pW/✓ C, SAA/ SoSF Lot No.
USE OF BUILDING
280-30(9-73) I Signed ----------
918 OLD TOWN CT OWNER
c W0 � io > C c ST OOtno a o 0 DArT W IE �
O l d C IU -• J y O 1' j J N N N 0 O 0 0 0
m � E -• 3 _ m o J` o_v o J .. rc' m >- >- ^ o r A A
co
gn
a ca s W v W
.T v
S 9 9 9 m � N O O �, K' M O G H O H• O H
d T adT o_ C) m 1
q s o 0 00 T "
A m m m m m .O T g X m o m m o Z
N' Hm N " On^ m° < m ' Am m
2.
M M
1 J r O !; -0 m n Z
v� o , 1 w O 0