21101 (2) 7507 PMOLTZEN DRIVE /
Building Permit Confirmed 2
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date--------- ---------------------------- 19.Z.6. Permit No.------- -----"----------
The undersigned here y makes ap kali to the Plumbing Inspector of the City of San Jose
for a permit To ins}all u i �or li Ted reverse side.
Esemption from r q r e o ifoy c}or's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑ /7/ j--37
Undersigned attests that his State of California Contractor's License
is in full force and effect and properly authoriz hi plic , ^
San Jose City Business License # io 5 61A / kap
I certify that in the performance of the wor for which this permit is issued I Oall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER -r2E,JELL
TRAC'- ADDRESS -7S"o MOL-TM(FA4 Lot No. II
Seo �Gd.
USE OF BUILDING
280-30(9-731 Signed ........ - .........
7507 MOLTZEN DRIVE CENTRAL SERVICE
c a N 1 f D C NST_ O O _N a
690 � O
J O N C n S T
a O C O N N
1 N
W D W� W9 W9 T N GSE y ; T � ZfoN
O3rm -- m T � "{ D_, A O 2 m O T R A O O' M m p Z
-m m r.
m s z
�� Igro 0 ��