13240 7552 Peach Blossom Dr:. 17
Building Permit Confirmed ❑
Not Required —'
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
-2—
Date------------------- ---�- —(Y.. 197 Permit No.--------------1-..✓... fLYv.........
The undersigned hereby, �}p WitiQ? fbe PJ rm6in'rr nspJEfo of the City of San Jose
for a permit to install plu 'ebb nN�lu'r s.a idd� spos�}iits�AtFe�re�rsa side.
Exemption from requirement for to of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ sst Cement filed
Undersigned attests the+ his State of Califon g 6#P-ac}atf L� n 2 f 7 c,36
is in full force and effect and properly authori:eyAiioapplilWon~�[�{!VVV,,,
San Jose City Business License # / s /
I certify that in the performance of the work for which this permit is issued I shall not employ
any person in any manner7 so as to violate the workmen's compensation laws of California.
OWNER IA, C--S C •
ADDRESS 7 rr` /0L7K'1y /;Lussan r)R Lot No.
USE OF BUILDING
280-30(9-73) Signed .c Ce- ..- --�- - -.......... .......�_-...-.
7552 Peach Blossom Dr. Ace
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