3977 (2) 7325 Fallen Leaf Ln
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date--- ------ ------------ 19..------ Permit No.--------- ..z.. .._/
-------------
The undersigned h�rRby makes application to the Plumbing Inspector of the City of San Jose
for a permit to insfalf)pdm8' G,,3i pi s P ed on the reverse side.
Exemption from�re'¢ui� ent Ik C i -i�r Contractor's License is hereby claimed
by undersigned: as own El at�n4��*a
/ d ^^� 4Undersigned attests that his State/6 alifornia C r], o ' LiM�isL- a l�L�/
is in full force and effect and properly out,, Fixes i is/app4ation.
#'
San Jose City Business License !! L F /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.-
Ow�R n/ l/ �uF'
lio
ADBRES>i!'2 FI�7 -L roV YI-)-� -Lv.. Lot N GdE
USE OF BUILDING �S�
280.30 Signed ---— .. ... ............ -------------------------------....
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