23534 (2) 1179 STAFFORD DRIVE
9 Building Permit Confirmed
Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR
FOR PLUMBING and/or GAS PIPING PERMIT
Date-NIL. -f------ ----------------- 19 1/ Permit No....l�l-S y-.....--"----
The un rsign.d hereby makes application to the Plumbing Inspector of the City of San Jose
for a permi to install p�iingif xfurea�47 pipes II#�n�fhd reverse side.
Exemption from regmremenf for Sate�of California for Contractor's License is hereby claimed
by undersigned: �s owner ❑ s}a}ement filed /a
Undersigned attests that his State of California Contractor's License #
is in full force and effect and properly authoorriizz s }h1 application.,n
San Jose City Business License
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.
/
OWNER ZAni l'G�(J(-S���
ADDRESS �J ,I�J S 7f 'n�/�/� Lot No.
USE OF BUILDING
280-30(9-73). Signed
1179 STAFFORD DRIVE',- ACE
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