39908 (2) 1059 -TLTSCAW 'PLACE
49 Building Permit Confirmed„2--*,
Not Required ❑
CITY'OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBINGand/or GAS PIPPING PE MIT
Date-- .....1. -?
-----3..... . ,.................+ 19.7q Permi# No.-- ` -� ....................-..
The undersignedhereby makes application to the Plumbing Inspector of the City of San Jose
'for a permit to install plumbing fixtures and/or pipes listed on the reverse side.
Exemption from requirement for State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that his State of California Contractor's License #,23/7
is in full force and effect and properly authorizes this application. u/Q Q�O
San Jose City Business License # {—I /
I certify that'in the performance of the work for which this permit is issued I shell not employ '
any person in any man r so as to violate the/workmen's compensation laws of California.
OWNER L( T /X tXl r �n1 I
ADDRESS a5' / .A 11A I Lot No.
USE OF BUILDING.
Signed --
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280-?+Oln
1059 CTUSCAML)-EL LE STTNSET POOLS
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