16332 936 September Drive
Building Permit Confirmed
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
-��.Date-- .'.....`�-------------------------- 19<.�Permit No.-- 6- ..2 ----------
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
for a permit to install pi e,14 fsR �/7a/,�,��d.-{(/�y�7��®��Pe���.�/+a��°�"/'�1y���/averse side.
Exemption from raqui LJ Efi✓fsT rotatement License is hereby claimed
by undersigned: owner ❑ statement filed ❑
Undersigned attests that his State of California Co cfors License #
is in full force and effect and properly authorizes this a wn.
San Jose City Business License # ��( (�
I certify that in the performance of the work for which this permit is issued I shall not employ
any person in anym�nner so as to .iolafe the workmen's compensation laws of California.
OWNER TA/sr4 1 J, C<<
ADDRESS 934 J-92� L&L Lot No.
USE OF BUILDING �- �'^/J 0
280-30(9-73) Signed---_7_•+'.0 - -------- ....� i---------
936 September Drive owner
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