18755• :2111111jalm• ••
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
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APPLICATION FOR
FOR PLUMBING and/or GAS PIPING PERMIT
Date' -'�a 5-5� IP-�Permit No. - 1-"'- .------------------------------
-------------------------
The undersigned hereby makes ;a licafion to file Plur ing Inspector of the City of San Jose
for a permit to install plumbing fi re�a� r pipes I'afed7 on fie r versa id'e.
Esemption from requirement fOrsSfate W"Caldo>✓a fm C�a��s•`rce s�hereby claimed
'04 by undersigned: as owner.4n statement filed
f` Undersigned attests that his State of California Confracfor� License
t is in full force and effect and properly authorizes this applica'tt//ion.��
sip San Jose City Business License # ��7�'r' (Y«6/�i
^' I certify that in the performance of the work for which this permi} is issued I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER _0 ) ) / �j
ADDRESS �����Li/d77 /)��SG%i Lot No.
USE OF BUILDING
O 280-30 (9-73) Signed
7465 PLUM BLOSSOM ACE PLBG
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