20369 (2) 7543 MOLTZEN DR ad'.
y
I 3av, Building Permit Confirmed
Not Required ❑
,CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING_ and/or GAS PIPING PERMIT
Date - -- f ...-- - -------- 19.7-(� Permit NoC2- - ---'--=-
The undersigned hereby makes applicaf' n to the Plumb' Inspector of the City of San Jose
for a permit to install u ,x s /0 6 li the reverse side. .
Exemption from r , m or e a f on tractor's License is hereby claimed
by undersigned: jas owner ❑ statement filed ❑
Undersignedatfest?•,that his State of Calif at�cfo �/7�C�`37
is.in.full force and.effact;and properly authoriz 4 pli
]'.San Jose City Business License # �.�
.I certify that in the performance of the work for which this permit is isss d I shell not employ
.+any person in any manner so as to violate the workmen's compensation laws of California.
OWNER ZVAGr Seo
ADDRESS 7�¢ 3 /7dL72E� (/� Lot No. /3
USE OF BUILDING
Signed. -SJ w/L11-L` .�- YHC.-----------
280-30(9-73) . I
7543 MOLTZEN DR CENTRAL SERVICE '
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