104241118 Yorkshire Dr.
Building Permit Confirmed ❑
1 Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date ------ -.7.:�-------------------------- -- 19-7T Permil No. -------/.D /.A
----------------
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
for a permit io install plumbing Au ad pipes batedioso ♦9rse side.
Exemption from requirej/St3'1e of:C'alfforfda for'C�rif�fiefo(S Licensgg,,is hereby claimed
by undersigned: as owner ❑ statement filed L�
Undersigned attests that his State of California C ?dors Li se kO�
is in full force and effect and properly aui or-iys this sip"lica c,
San Jose City Business License # Gy '/7
I certify that in the performance of the work for which this permit is issued I shall not employ
any person in any manger so as to v^late.th workmen's compensation laws of California.
OWNER
Lot No.
ADDRESS
USE OF BUILDING
i
280-30
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