56174 7960 SUNDERLAND DR. '
Building Permit Confirmed ❑
Not Required C�
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date26 14 Permit No. 7y
The undersigned hereby makes application to the Plumbing Inspector of the City of San
Jose for a permit to install Plumbing fixtures andlor pipes listed on the reverse side.
Exemption from requirement for State of California for Contractor's License is hereby
claimed by undersigned: as owner ❑ ' statement filed ❑�/
Undersigned attests that his State of California Contractor's License
is in full force and effect and properly authorizes this ap tic tion.
San Jose City Business License fl I'ii<< s5_ Rl
I certify that in the performance of the work for which this permit is issued I shall not
employ any person in any manner so as to violate the workmen's compensation laws of
California.
Job Address n0 ��� �/J/ �C` Lot No.
Owner Tract No.
Permittee �7 t -
USEOFBUILDING 410 Signed
2804
CE. U (/
7960 SUNDERLAND DR. I
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