23363 Lot6 1028 TUSCANY PLACE
P[A v 7 Building Permit Confirmp
e —�,�/
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date--------------.-9--/?. 197:// Permit No. ..................
The undersigned hereby makes application to the Plum bin nspector of the City of San Jose
for a permit to install plumbi i i n he reverse side.
Exemption from require i r i for ontrac}or's License is hereby claimed
by undersigned: a ,owner statement filed ❑
Undersigned attests that his State of Califor Confredtor's License # /66998
is in full force and effect and properly aufhorize�yplicefio�
San Jose City Business License # �( ( E
1 certify that in the performance of the work for which thiz•permit is issued Ixshall not employ
any person in any manner so as to//viola}e the work//men's compensa}ion laws of California.
Fo
OWNER N4eVOSA 110'Ves S1 Y3 r
ADDRESS 1029 TUSCDAiIX/ PGfiCe Lot No.
USE OF BUILDING I�'S/d2NG e
280-30(9-73) Signed CYOtvL° C..........................y ....--CC
1028 TUSCANY PLACE CROWLEY.,
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