20293 -828-ROSE SLOSSOM7 DR
Building Permit Confirmed El
Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or CTAS PIPING PERMIT
Date---- ).T-- )4A,-Lh.,3..... -' .. 19211- Permit No.--- Z
The undersigned hereby mak plica+ion fo the R•mbin Inspector of the City of Sen Jose
fora permit'to install gPlumbirc fi r r o o re c 'ide.
Erem tion from re uireme o rn� o. r iconse is herebyclaimed
by undersigned: as ow -r ❑ statement filed 0
- Undersigned attests that his State of California ontractor's License
—'..'is in 'full force and effect and properly authon:oz is Hca+ion
San Jose City.Bu
siness%License #—M— __ —� l�
I certify thaf'in the performance of the work or w ich +his perm@ is issued I shell not employ
r any person in any er sp�az fo viola}e the workmen's compensation laws o4 California.
OWNERy /✓� �J
ADDRESS ��0 lU�_e, A/ Z4 Lot No.
USE OF BUILDING—/�✓
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828 ROSE BLOSSOM DR ACE
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-828-ROSE SLOSSOM7 DR
Building Permit Confirmed El
Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or CTAS PIPING PERMIT
Date---- ).T-- )4A,-Lh.,3..... -' .. 19211- Permit No.--- Z
The undersigned hereby mak plica+ion fo the R•mbin Inspector of the City of Sen Jose
fora permit'to install gPlumbirc fi r r o o re c 'ide.
Erem tion from re uireme o rn� o. r iconse is herebyclaimed
by undersigned: as ow -r ❑ statement filed 0
- Undersigned attests that his State of California ontractor's License
—'..'is in 'full force and effect and properly authon:oz is Hca+ion
San Jose City.Bu
siness%License #—M— __ —� l�
I certify thaf'in the performance of the work or w ich +his perm@ is issued I shell not employ
r any person in any er sp�az fo viola}e the workmen's compensation laws o4 California.
OWNERy /✓� �J
ADDRESS ��0 lU�_e, A/ Z4 Lot No.
USE OF BUILDING—/�✓
280-30(9-73) Signed.. i ------ --�,
828 ROSE BLOSSOM DR ACE
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