34526 7917 RAINBOW na VE
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE 91 BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
' oZ/
Date.......... -.....- - ---
. 19.7.... Permit No. - - -- - �------------------
Th.
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The under 'g ad hereby kes application to the Plumbing Inspe r of }ha Ci of San Jose
for a permit to ins}ell plu a 0 rs¢ side.
Exemption from requ ie r r s License is hereby claimed
by undersigned: owner statement filed ❑
Undersigned attests that his State of California Contractor's License #
is in full force and effect and properly au}h• applica '
San Jose City Business License # y-
I certify that in the performance of the work for which this permit is issue I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California. 'f
OWNER cJ4, k4 ,,
�� 17 �t'1L-� J/✓
ADDRESS Lot No./ —
USE OF BUILDING 9f•ti4
Signed....... �.......-'Y�-�q G---------------......
���/// 280-401n
.7917 RAINBOW DRIVE OWNER,
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