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e><{q. Bwldi giPermi4 Confirmed ❑
No} Regmrad ❑
CITY OF." SAN JOSBUILDING DEPARTMENT y;
APPLI'00.CATIOR,,FOR PLUMBING and/ GAS, PIPING (PERMIT
Date41 - / �... k ....:�_ 1�9�/:. Permit No. .Z ,��"' ..
x Tha-unders/igned hereby m plc fion to'h6,Plumping Ins cfor of iha Cif y�of San°Joso -
for a permit }o ins}all pumbi r po a ed n e.erse side.
Exemption from requireme or a e all o i11
e" for's License is hereby claimed ,
by undersigned: - �as j,yner ❑ statement filed ❑_ '
"Unde'rsignad aHesh that his Sfafa'-:of California"C tractors Llicense
is in full force and pfSac4 and properly authorizes }his�/+di ;-d7n a ���'
San Jose City Business License # -e/9l `•
,❑ I certify that in.fhe'`Iperformance of the work for which—this' perm f
W m issued I Aaff not'em ploy
any person.
OWNER
ADDRESS � � rJ� S^/�O/��7�� ti)��` Lot No.
USE OF BUILDINGA .
...... ......
9✓ � J 2B0-401,N
ACE' ;'
1174 SCOTLAND DHC VE
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