26436 (2) 765'3' PEACHiB `OS50M DRIVE DeA"ye)zAT'o"6
ui�mit Confirmed
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date...
...-2'.-..I 19 � Permit No...............ZZe)51�(.........
. - .. ...
The*undersigned hereby/Ifes'fepplleafion�P fh)PI'urt'bin r nipecfor of the City of San Jose
for a permit fo'install plumbing dyuresMad%or.piosolisstSd o reverse side.
Est,Z ioo from requirement for State of California for Contractor's License is hereby claimed
by undersigned: as ownar�p statement filed ❑
Undersigned attests that his State of�C California CpntrEyfe{y's L'igenrae Z
is in full force and effect and properly pu+hes thi ai,5 i-fi�V
San Jose City Business License # — r l 181
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 to violate/the workmen's compensation laws of California.
OWNER To N Y L- n:u A
ADDRESS 7( p
G S 3 0 �a e � 1% (0550",A Dr, . Lot No.
USE OF BUILDING
' Signed.....�...�....---- �---- ( ------------ ---- —....
280-•401n
7653 PEACH BLOSSOM DRIVE WESEN CONST.
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