16275 924 Sage Court ( �
"� Building Permit Confirmed LRS
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GARS PIPING PERMIT
Date....... --------------------- 19-------- Permit No4.-;.;?--.7-- -----------------
The undersigned hereby makes pp ice{ion }o the Plum bin %spec f the City of Sen Jose
for a permit {o ins}all plumbing ixtu o }ed n e side.
Exemption from requiremen { a o nia ra o License is hereby claimed
by undersigned: as owne ❑ statement filed ❑ y n y
Undersigned attests that his State California Conlrac4 s License
is in full force and effect and properly authorizes this
appl., io Y
San Jose City Business License # 4'�1Z-L-r,�
I certify that in the performance of the work for which tis permit is issued I shall t employ
any person in any/manner so as to violate the workmen's compensation laws of California.
OWNER / num f/Si0y 9 .,t.
ADDRESS ��C/ A G! Lot No.
USE OF BUILDING_rz S
C
2BO-30(9-73) Signed �1----------..
924 Sage Courtry
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