24112 (2) RWOOD CT 7
Building Permit Confirmed/
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date--------------------------_------V.-3D... l9�k../ Permit No------;?—._Y/(...2�---------------
The undersigned her a ss I'�je�' f theme P�r+�f/n pector of the City of San Jose
for a permit fo install lu 'u ��%taahi�NQ/of�iPes Jiti(Y6rYfha ro.arse side.
-Exemption from requuemen for Ste e o California for Contractor's License is hereby claimed
by undersigned: as owner ❑ s fa nt ed'
Undersigned attests that his State of C nw Co i ns
is in full force and effect and properly aut rims app ication. O T /
San Jose City Business License #
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 f violate the workmen's compensation laws of California.
OWNER Pa/� ��os/�- NOyI�S
D — Lot No.
ADDRESS lQ
r
USE OF BUILDING
Signed----CrO.W --'-- .. -
280-30 (9-73)
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