30262 7394 WILDFLOWER WY.
Building Permit Confirmed
Not Required ❑
CITY OF SAN JOSE q BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date.........--- .-..197-., C....... 19- Permit No.... �Y'...�..L....----------
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
for a permit to install plumbing fixtures n�orxrpiP�'s/ed70 6e'ree�d
Exemption from requirement fo` Sta�i�f Celiiorni�lfor.Gpritra tor;s'Lrcenae is hereby claimed
by undersigned: es owner [` statement filed
Undersigned attests that his State of California Contractor's License # �G477�—�t3
is in full force and effect and properly authorizes this—apppllication. e..-
San Jose City Business License # ��'o :92 =T
I certify that in the performance of the work for whichlhis permit is issued 1 shall not-employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER ,��/[ rrT� d t
ADDRESS (( Lo+ No.
USE OF BUILDING
Signed �NC ��� ..P4kOU
I
r-, 280-401n
7394 WILDFLOWER WAY ADMIRAL) POOLS
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