8189 1203 Yorkshire
G Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date------------------------- - ------ 197.`1... Permit No.----------- /_lvi-----------
The undersigned hereby makesAp plication to the Plumbing Inspector of the City of San Jose
for a permit to install plumbing fix3u�r sand or Rrpes 4fod t ¢lro`1vers -ido.
Exemption from requirement`�fko.,a rd n�o C�idtaaaaf'or%.License is hereby claimed
by undersigned: as ow ❑ statement filed ❑ 37
Undersigned attests that his State of California C4ntractor's License #
is in full force and effect and properly authorizes t��pr�pf�lcation �q
San Jose City Business License # �/4/
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 GL12rc!/ 1
ADDRESS Yo2KsHrKC' 7�2 Lot No.
USE OF BUILDING f S
. p Ce?:-cci-L:_@�?��,4"'✓
Signed . C�..Y. --'--" 1/" ----------------------..
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1203 Yorkshire Ace
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