29945 (2) 1075 KENTWOOD
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICA BING NN FOR PLUMand/or GAS PIPING PERMIT
��
Date..---�/......f..----- ------------------- 19� Permit No.. .Q.�..�......_...............
The undersigned her y makes ap licet' n to the Plumbin Inspector of the City of San Jose
for a permit fo instal
pl. /o pip z sf fha reverse side.
Exemption from r e eli i orrfractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑ _
Undersigned effes}s that s 5 ale of California Co tre tor's License # �,a R 3 9!
9 yw� �
is in full force and effected r I euth a h' pp' ion
Sen Jose Ci fy Business L' en
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 fq s'jolate the workmen's compensation laws of California. '
OWNER /{V/IJ
ADDRESS / D 7 S: �(�� �i� fJ Lof No.
USE OF BUILDING
Signed C./D,, ..G...//},ta�sCA.....(...F..f?�:. ../�": �
280401n
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