76437 (2) 619 Min, COURT
r Building Permit Confirmed
-Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date---------------... ...... ..... 19.71.- Permit No_! -.�-.r�.. Z--..--..
The undersigned here b]]II/ma es application to the Plum bin Inspe for of the City of San Jose
for a permit to install pl bi f( / res and%oripe�s isfad h ' reverse side.
Exemption from requrremen! fj SRix CSlifSmiaf.fo Con"liax:4 i License is hereby claimed
by undersigned: s owner ❑ statement filed ❑
Undersigned attests that his State of California Contractor's Licensees#
is in full force and affect and properly au} s�}liis.eppl ica}I'1 n.���!! /�
San Jose City Business License # }b' /�/6/ �f'
I certify that in the performance of the work for which this permit is issurd 1 hall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNERS
ADDRESS �� �� e� -- ��� Lot No.
USE OF BUILDING -^
Signed
f/okrr Co��lT
280-401n
619 PHIL COURT HOUTS CONST.
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