39592 (2) 1085 MILK WAYPHONE 2]]-4581
Building Permit Confirmed ❑
Not Required ❑.
CITY OF SAN JOSE BUILDING DEPARTMENT.
APPLICATION FOR. PLUMBING and/or GAS PIPING' PERMIT
Date....:._. .....l..4.......... 19/9F Permit No. 3.�f --9-2.,....--.........:...
- The undersigned hereb make a Ic on 1he P bipg nsV of the city of San Jose
s, for a permit to install p m i r pipe isf d r arse side.
Eremptlon fromreqn tote Ca or is or Contractors License is hereby claimed
by*undersigned: owner statement filed ❑
Undersigned aHests that his State of alif������[nn++++m ontrac}or's License # ,
is in full force and effect and properly aufhori �! plicariw
San Jose City Business License $k
I certify that in the performance of the work for which this permit is issue 'I shall not employ
ny person,
OWNER ^s
ADDRESS D S Loi No.
USE OF .BUILDING _C��_
'r ,Signed ..... .. ...F... ----'.......
280-401N
1085 MILKY WAY OWNER
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