31672 (2) 1103 MILKY WAY �` , n
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YN.P�,r '� Building Permit Confirmed ❑
�li"1 �J
Not Required ❑
CITY OF SAN JOSE r BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
// ? /.7 .
Date.'J --I-------------- 191..fit).. Permif No. �L/J ..................
The undersigned hereby a c i f' } lu Inspector of the City of Sen Jose
for a permit to install
plu r or i is n the reverse side.
Exemption from requirement f r Sfal of ornia for Contractor's License is hereby claimed
by undersigned: s owner ❑ statement filed ❑ fir`
Undersigned attests that his State of Qplifornia Contractor's License # e;2 ? " �a
is in full force and effect and properly nut z//Cs�/thisf{.p��� ��
San Jose City Business License # 411 /{v s/f/ x-
I certify that in the performance of the work for w ich this permit i issued I shall not employ
any person in any:mma r. s es to violate t.he workmen's compensation laws of California.
OWNER�LSLt/� �
ADDRESS 3 of No.
USE OF BUILDIN L
1
Signed ../—.......�..�'c.'"_" .-------
280�,401n
1103 MILKY WAY A & B TERMITTE. CONTR01
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