24110 (2) 7612
7{ 415} yRW00D CT 3
Building Permit Confirmed��/
Not Required .❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
- - o
Date-------------- ------
---------Q..-JD_ 19.745.' Permit No.---- --------------------
The undersigned herwby,makes application to the Plumhin Inspector of the City of San Jose
Fore permit }o ins} pl fi ur oi—��°s' e o the reverse side.
Exemption fro 'r or f�ae K o onfracfor's License is hereby claimed
Isy undersigned: / as owner ❑ statamenf filed ❑ // cl/ 79_
Undersigned attests that his Sfaf of California Contractor's License # ((J/> < / O
is in full force and effect and proper u orixes A' p 'c
San
San Jose City Business License /U/// / /
I certify that in the performance of the work for which this perm} is issued I shall not employ
any person in any Tanner so as to violate the workmen's compensation'laws of California.
OWNER /0,11de s�
ADDRESS p Lot' No.
USE OF BUILDING
Signed-:-CI�I/7�GE �.. -----------
280.30(9-73) • . � i -----....---...---�--.. ..
7612 .ELDERWOOD CT CROWLEY
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