9120 (2) 10.38 Cransberry drive
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE I BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date -y/-7�-5".f//'.-423------------------- 1925 . Permit No..... ..................
�/-Z.P......
The undersl d hereby makes applicaiion to the Plumbing Inspa of !he City of San Jose
for a permit to install plumbing fixtures and/or pipes listed on revers ide.
Exemption from requirement for Stale of California to o r ct nse is hereby claimed
by undersigned: as owner t t iled 9"
Undersigned attests th his State of I' nia ra s License #C.S�$'e799 StiS nl
is in full force and off c+ a d pro art a riz s i a cation.
San Jose City Bus' ass Licen U �2 —
I certify that in i e perfor a of the ork for which this permit is issued I shall not employ
any person in any me r so s to violat i a workmen's compensation laws of California.
OWNER
ADDRESS Lot No
USE OF BUILDING
280.30 Signed . (�..�/�
'-- - ---------- .,.1./.7. �. ........_-_..... .....
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1038 Cranberry dr vals
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