3690 (2) 7689 Peach Blossom
Building Permit Confirmed 12--�
No} Required ❑
. CITY OF SAN JOSE BUILDING DEPARTMENT
APPLIICATIO/NFFOR PLUMBING and/or GAS PIPING/PEERpMI IT
Da{e.---,Y--- --/---FJ ---------------- 19--� ermi{ No ................... L?..L..v.........
The undersigned hereby me�kes�aEp�ic�tio to/fye an
the City of San Jose
for a permit to install pu�mb'ng (Gy�nid o� p[paf�liste�ron f�reLra�e'rsa side.
Exemption from requirement fortate of �fordia for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed El _
Undersigned attests that his State of CeSorni$"Contract
' L•ic n e # 3J�C 53
is in full force and effect and properlyautho 'nosPFti' a li W
San Jose City Business License �$N ~ �
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.
OWNERX( �y
ADDRESS � ��/ s ��t2? Lo+ No. �' 9
USE OF BUILDING
280 30
Signed .. 0 ' �' - -----------
Jk d'z
Ap ,che
7689 Peach, $14sS4m. ( , .
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