40003 a 1024 -TU86ANY PLACE', PHONE 27 e� ,.Z..'
Building-PermdsConfirmed ❑ -
_f Mays }tfp Not Required',
CITtyt 'F SAN JOSE, i'„'",, . 4mBUILDING 'DEPARTMENP'hotj
rY APPLICATION FOR, P U,MBING 'and%or .GAS,t:PIPiNG PERMIT (5
7 : �p
Date / ._ r^ : . .: 19 (... :Permit No.
The'undersigned hereby makes applicel on to the Plumbi :Inspectp }he City of San Jesa
- .fora permd }o install-pi f r o ip 4 } o the reverse side at
Eae pfion"-from req r r F o eli ornia or., onirector s License is harakiy,cleimed°
by uncle signed: a_ s ow net' ] r•: statement filed-❑ ;'" t
Undersigned attests that his`State of California o for�(jy9/se/
is.in fu l `forie and effect and properly authorizes,th�y ceff sC'd �V� �?�✓� .r Y -
San Jose City Business License -
"0'I certify that in the performance of the work for which this permit is issued I shall not employ
any person.
i
OWNER l�-r+- Cdr/
ADDRESS 7y Z F (SSC_ P�a�E' Lei NO.
w USE-,OF BUILDING
Signed . . .
280-401N
1U24,TUSCANYOPLA Ek' . V,
OWNFR: