23364 (2) Lot 3 U 1036 TUSCANY PLACE
PlAA' `(/ Building Permit Confirm
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION
FOR PLUMBING and/or GAS PIPING PERMIT
Date-----------------------V.- ./. .._--- - 1970/ Permit No.... /... --�P. _..._.......
The undersigned hereby kos aPp
licafion to the Plumbing Inspector of the ity of San Jose
for a permit to insfall plum n 'xf ' fa he reverse side.
Exemption from require i r is o ntractor's License is hereby claimed
by undersigned: owner ❑ statement filed W Undersigned attests that his State of California of fors ere b
is in full force and effect and properly authorizes t is atio .
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 PNaerosA 11CA4,PS ?
ADDRESS /036 TTvscAAyy Place Lot No. 3
USE OF BUILDING / ,f5-1' eyc-e
280-30(9-73) Signed ned.. YO.V?�� -`-/------ _ - -
Q------.. .--------- --- ---
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, 1036 TUSCANY PLACE CROWLEY
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