30591 1118 5 tm.ECHA9E LANE
Building Permit Confirmed l-
�/�,
Not Required L4�
CITY OF SAN JOSE C� BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
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Date -1='-1. . ..7 19 7.. Permit No. - .. ...........!.../- ........
...
The undersigned hereby ekes application to the Plumbing Inspector,of the City of Sen Jose
for a permit to in plurf s / IYs d t a ravdrsa side.
Exemption from requir6 e a 10 i rector's License is hereby claimed
by undersigned: s owner statement filed ❑
Undersigned attests that his State o California� g�onfiactor's License #
is in full force and effect and properly authorizes th' a2a}io
San Jose City Business License # ((//L
I certify that in }he performance of the work for which this permit is issue shall not employ
any parson in any ennar so as to violate the workman's compensation laws of California.
OWNER ir n (— 1LG�A_4QAA 1
ADDRESS I g Lot No.
USE'OF BUILDING
Signe .. . ".
280-401n
1118 STEEPLECHASE LANE OWNER
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