19302 (2) 7513 Rainbow
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING PERMIT
Date... . .................195-,R --- Permit No.----.I-E-Z- 9--2
The undersigned hgr€Ijy figs pppl}tati af,; hg�lymbing Inspector of the City of
San Jose for a per m f' /or pipes listed on the reverse
side hereof, and agrees to install said fixtures and/or pipes in accordance with the
provisions of Article VIII, Chapter 22re Saq¢legg Jvl m ' I /node, and all other
laws applicable thereto. 7V//f .OWNER ..... ` ' ...:�...? --
�y
ADDRESS .....Z5-� ....-�4i[.a�/'l!'G(r-� i-P /----•-
USE OF BUILDING ... ....................-......... ---------�---..j... -
Signed -- - --- - -------f7••---rrL:��l:•"-=�-=-------- -------_:..i
Form 200.30
7513 X Rainb0i,.,
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