40528 (2) 7507 -DE LA FARCE PHONE: 27714581
Building Permit Confirmed
I~ Not Required ❑ s-
CITY OF .SAN JOSE, BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and or GAS PIPING PERMIT
Date..] - fc. ....... ................ ......I. 19.1..1p.. Permit No........,......¢ �Z. ........:::.
The undersigned herob makes application to the Plumb�'p� Inspector of the City of San Jose
for a permit ft install p r�i r���J�aJ�"j,,�' the reverse side.
Exemption from r uir o ia�iksr�Contrador's License is hereby claimed
by undersigned: as owner statement filed
Undersigned attests that is State.'0f r i ontract r License
is in full force and effect and properly aut or appli i
San Jose City Business License # L
❑ I certify that in the performance of the work for which this permit.is its ed I shall not employ
any person. r
OWNER 1 /� ROI �f I -
ADDRESS _ S•-&dam. Lot-No.
USE OF BUILDING :� �r1q, F `J�ile���hG RESthen�d
- Signed .l'.C_•'^'t. ...�. '�YVe . .'
280-40tH
7507 DE LA FARGE BIONS CONST
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