19809 (2) 7541-WATERFURE)--- UK
Building Permit Confirmed ❑
Not Required
Er-
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
i
Date"...-/ s..""7"---...." I S�/�. Permit No./---
---- ------------------
The undersigned hereby m es ar1plica+ion to the Plumbing Inspector of the City of Sen Jose
for a permit to install plum n f' e } verso sido.
Exemption from require n r tae ie - or's License is hereby claimed
by undersigned: a owner statement filed
Undersigned attests that his State of California + or' '
is in full force and effect and properly au+horizos thti
San Jose City Business License *r ornia 7:,:1
I certify that in the performance of the work for-which }his permit is issued I shall not employ
any person in any manner so astoo violate thh workmen's compensation laws of California.
OWNER.,j_au(-,� 'v/C/!
ADDRESS ���/�/ 02A/� Lot No.
USE OF BUILDING
280-30(9-73) Signed. �fI.". .. ------ - ------ ...
7541 WATERFORD DR
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