41503 (2) i659 TtJSCAN�' PY�ACE
Building Permit Confirmed
Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBINGand/or GASPIPINGPERMIT
Dafe_... ------3/--- ........ 197.G Permif No.------ ...................
The undersigned hereby 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 # •7Q�_ r—�L� �—j
is in full force and effect and properly authorizes this application.
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 it) J
ADDRESS T P2 Lot No.
USE OF BUILDING
.t, Signed ... . ..1�.(�..L .--- .,.., L�
(4�0�TUSCANY
N4,oylq,110k� k�lPn01, 280-401n
105PLACE SUN ET POOLS
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