20665 (2) 1382 STELLING
Building Permit Confirmed 9-
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Da#e /S`----...-----.. 19. ? Permi# No. ..U...�D-------------------------------
The
..�.....----------...----The undersigned here makes applicafion to the Plumbing Ins actor of the City of San Jose
for a permit tc install m e r pi t o averse side.
Exemption from ra r o orri o rr's License is hereby claimed
by undersigned: as owner ❑ statement filed .D 6�
Undersigned attests that his State of Califpr�nia Contractor's License #
is in full force a� effect and properly authori>�y) pplicas nn. � ,,/
San Jose Ci} Business License /7/� / %�i'�L/
I certify that in the performance of the work Tor which this permit is issue I shall not employ
any person in any manner—so as to violate the workmen's compensation laws of California.
OWNER „�fI / LAY o/✓S /— //VC.
ADDRESS .Z fE /if/ Lot No.
USE OF BUILDING —e—S
SgCAr/7IU4 -280-30 (9-73) inedl . --U----
1382
STELLING CAMPBELL PLBG
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