23360 tot 1,9 IG29 TUSCANY PLACE
PIAN 3
Building Permit Confirmed—Er--
Not
onfirmedNot Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date-----------------------------5-�..r7.-...... 19. 6 Permit No-_7�-3—'J 6w.'.....--------------
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
fora permit to install plu i�spi �ha reverse lido.
Exemption from requir e o i niractor's License is hereby claimed
by undersigned: owner ❑'go statement filed ❑/
Undersigned attests that his State of California goontrecfor's License # 00 1
is in full force and effect and properly authorizes WAIicefi
San Jose City Business License # iQ
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.
OWNER TO�7 ale".OS,4 110,wes C^��-
ADDRESS 19.2F TpS CAiYy / LAC° Lot No. �D
USE OF BUILDING
280-30 (9-73) Signed YOWL�y...CA .
1029 JUSCANY PLACE CROWLEY
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