29123 (2) 866 E ESTATES DR
Building Permit Confirmed
Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Da+e---f� ........;,S............... 1977.. Permit No.------y-6-o -----...---
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
for a permit to install plumbing fixtures and/or pipes listed on the reverse side.
Exemption from requirement for State of California for Contractor's License is hereby claimed
by undersigned: as owner 0 sfatemont filed
Undersigned attests that his State of California Contiactor's License #- y ly 36
is in full force and effect and properlyauthorizes is ep licgfion
San Jose City Business License #N7 ��S `J
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 to violate the workmen's compensation laws of California.
OWNER
ADDRESSl �jT�S 1�>" Lot No.
USE OF BUILDING 205:1 Y
280-401n
866 E ESTATES DR NATIONAL SERVICE
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