14593 (2) 831 September ct.
Building Permit Confirmed ❑
q Not Required ❑
CITY OF SAN JOSE ` BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GADJS PIPING PERMIT
Date------.....-----------.----s.a.�-----l-Z- 19-2t-S'—Permit No.L.� � -----------------------
The undersigned hereby m p i t' n t the PI bing In actor of the City of San Jose
for a permit to install plum i i d to
side.
Exemption from requiram(((e//ntN✓✓fo fe e o Ca i r a for C rector's License is hereby claimed
by undersigned: a owner ❑ statement filed ❑
Undersigned attests that his State of Cali(ornm tr r'z License # `-- R of
is in an force and effect and properly eu�ri\-es thi � ��. .�// �
San Jose City Business License
I certify that in the performance of the work for which this permit is issued I all not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER
ADDRESS ()r?,/ ��/�%•'''�'�prLot No. &
USE OF BUILDING R— /
280-30 19-731 Signed----' -- '�!T..?.... .. - ------ ----
831 September . , Apache`
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