46799 (2) 1181 ELMSFORD Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAUSS PIPING PERMIT
Date--- ..........-L.0 .I�------------- 19C0. Permit No...7... ... ...7 .- '---'-----
N - `�
The undersigned hereb kcs eppljal'ax, }o he Plu ing Inspec}or of the City of San Jose
for a permit to install pl ps1 pi on the reverse side.
Exemption from re ,Jretor e el or a or Contractor's License is hereby claimed
by undersigned: as owner ❑ nistatement filed(
Undersigned attests that his State Califora Contractor's License #
is in full force and effect and properly hofffy'f a W,
San Jose City Business License # I r T—
I certify that in the performance of the work for which this pe it is issued I shall not employ
any person in any manner to as to violate the workmen's compensation laws of California.
Job Address /121 F� mS�� Lot No.
Owner Tract No.
Permittee
USE OF BUILDING Signed.�Q/�y'. - _. u�
�/ 280-401n
1181 ELMSFORD ACE PLUMBING
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