19806 (2) 1161 SO STELLING
Building Permit Confirmed F1 /
Not Required (�
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PPIPPIN�(G' PERMIT
Dafe----.lr... C�r..:....:�-r.. --.. 19 rj... Permit No.--------l.-.G. U...�L"--------------
The undersigned hereby s application to the Plumbing Inspector of the City of San Jose
for a permit to install plu m f' } �t/iy/}ed/ the revarse side.
Exemption from requir 'Vara tNQ4rac}or•s License is hereby claimed
by undersigned: a owner statement filed
Undersigned attests that his State of California ntractor's License
is in full force and effect and properly authorizes } i a tion.
San Jose City Business License # _���fYY�1iQf
I certify that in the performance of the work for which this permit is issue I shall not employ
any person in any manner so r to vviolate t e workmen' compensation laws of California.
OWNER__57eA
GCL/ �
ADDRESS �� LL �L�� Lof No.
USE OF BUILDING J —
_ 280-30 (9-73) Signed -' - -- -. .. _...... ... .. ... ---
1161 SO. STELLING / E�/�
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