12326 949 Rose Blossom Dr.
Building Permit Confirmed—E
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICA/TI��N FOR PLUMBING and/or GASPIPING PERMIT
Date--------- .......- - 19.7 / Permit No.. -//- ..3-��------------
Tho undersigned here akes application to the Plumbing Inspector of the City of San Jose
for a permit to install p m i e d �p is onn r verse side.
Exemption from requi en a '�o ni 6r� r or's License is hereby claimed
by undersigned: s owner sta amen+ filed ❑
Undersigned attests that his State of California Cont actor's License #
is in full force and effect and properly authorizes Phis
Sen Jose City Business License # ( C/R�je�
I certify that in the performance of the work for which this permit is issued I shall employ
any person in any me
so es to violate the workmencompensation laws of California.
OWNER
ADDRESS 9SU7 C�l7S ��/ �� ' Lot No-
USE OF BUILDING
280-30(9-13) Signe/- -- -- - --949 Rose Rose Blossom Dr. Murdoch
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