31608 1181 YORKSHIRE DR
Building Permit Confirmed Rj"
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION' FOR PLUMBING and/or GAS PIPING PERM4T
Date L�.... ._7.....---------------------- 191. . Permit No...... .G....r�...�.�............
The undersigned hereby makes application to the Plumbing inspector of the City of San Jose
for a permit to install plu m�;rig'fixfur s,and/B pipes lis�ted•on t��i�se side.
Exemption from requira�ntwF�Sfalarof�Celifornie�for'Coniraeores Lcense is hereby claimed
by undersigned: as of✓rner ❑ statement filed ❑
Undersigned attests that his State of California Con}iacfdr's License # zci 2
is in full force and 'eF{acf and properly euthorizfrs this,�pp�i( tt io x /
San Jose City Business License # 41t APS (O/V r���/
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
ADDRESS IV S ze- I? Lot .No.
USE OF BUILDING
Signed.. ..--..............-'o--- .. -----......--------"-'--
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1181 YORKSHIRE DR €K�&CONSTRUCTION
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