21638 (2) 902 EAST ESTATE DRIVE Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING2 PERMIT
Date._JI n Z-------/ .._----------... 19.7 Permit No.---- .1...�. _/..�-----------
The undersigned her m e� pli }' o bin n poctor of the City of Sen Jose
for a permit to install s or e n e reverse side.
Esemption from r qu�rommt for State of alifo nia for Contractor's License is hereby claimed
by undersigned: as owner ❑ stat ent filed ❑
Undersigned attests that his State of Cali r i tractor ns
is in full force and effect and properly author' 1Q7ie'applicefi
San Jose City Business License #— 9 —04-3 /
1 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 yiolate the workmen's compensation laws of California.
OWNER /Tdr�X
ADDRESS Lot No
USE OF BUILDING Jl
280-30(9-73) Signed ... ----- -
902 EAST ESTATE DRIVE APACHE POOLS
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