19750 (2) 81-23 PRESIDIO DR
Building Permit Confirmed
Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date--"-----------....-......... --------- ./ -
.. 19f�. Permit No. ./C--..9.
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The undersigned here y-m�fea applica 1 o the PI bing Inspector of the City of San Jose
for a permit tc install m n��`}i r and r e ad y'�j he reverse side.
Exemption from raq�irer '�Wit, o def �fo�C Wac}or's License is hereby claimed
by undersigned: (es owner ❑ statement filed [_I ,_y
Undersigned attests that his State of California Contractor's License # r �
is in full force and effect and properly aut riz.ithis e conn
San Jose City Business License # 4/ , � ��-//oma
I certify that in the performance of f oh this permit is issued I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNERF- i2%Sc-,—�
ADDRESS F-1.2.3 Lot No.
USE OF BUILDING
280-30(9-73) Signe � .....1. �...----- -----"'-J-----------------
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8123 PRESIDIO DR LAR Y?S-PLBG9�
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