6653 (2) 906 East Estates Way
/ff Building Permit Confirmed—e
jNot Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date..-------...------------/�- -�-/- .. 197'3. Permit No.._-----------Cl. s --------
The undersigned hereby makes application to }he,Plumbin pector of the City of San Jose
_ for a permit 4o instel b' /o pi /s�s} � n e reverse side.
Esempfion from � or a aliforni� ontractor's License is hereby claimed
by undersigned: es owner ❑ statement filed ❑ ,3 7 G
Undersigned attests that his State of Califor a o/nfracto
is in full force and effect and properly authorixo egpZ
San Jose City Business License # yy — �'� • y�
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 AY FR C
ADDRESS Cl �' 65774 7eS- 2 Lot No.
USE OF BUILDING S
SignedleGce..�&61'_f -"-r..1-------------------
28D 30
C- .�-28D30 (/
906 East Estates Way ace
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