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23494 (2) 1183 STAFFORD Building Permit Confirmed2 Not Required CITY OF SAN JOSE BUILDING DEPARTMENT APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT Date--- -=l --- ... ..----............... 19� Permit No.. .` .7../..... . The undersigned her makes application to the Plumbing Inspector of the City of San e for a permit To ins+all �,,,{�a i torr }nd or asppIisie�on�the reverse side. Exemption from requ rtrV�o> -elite is di Contrac+or's License is hereby claimed by undersigned: as owner ❑ statement filed �J Undersigned attests that his State of Califor}iretra }� Lic see— . is in full force and effect and properly authorial {hsia'p +fi6n San Jose City Business License #— I certify that in the performance of the work for which this perp t is issued I shall not employ any person in any manner so as to violate 4 e orlmen's compensation laws of California. OWNER ADDRESS 12� 3 S/G Q/ Lot No. USE OF BUILDING 280-30(9-73) Signed ��--------,--------------`---....-------'--.... G. u 1183 STAFFORD RC BLDRS DC c = m v ONo 0 0 0 07co T W o 1 On � o - � p ' rO '" 1N � � p " ipi � op �. uc n2X '♦ O F f p N o � v �. T C Q u o " " v� N " o o h v " l _ z 1 T 'CJ m m W D W W W 9 'ON 0 ::ey r T HZ 4EN 1 N 1 N � 3 � fjl � A � N �• pm " C c D � 3 m D D Tp A N m R m T o A �! o m A O Z v N " D � � Nm � A ' Av 1 m m N 2 o N c o D t� O 91 '.: m D Z A O i > O QQ 0 m