8727 6395 Bollinger
BuildingPermit Confirmed ❑
Not Required ❑
CITY OF SAW JOSE BUILDING DEPARTMENT
APPLICATION/ FOR PLUMBING and/or GAS PIPING PERMIT
Date.--------->�. ::1..--- .................. 14V Permit No ----- 7--.._----------------
The undersigned hereby mekes ep licafion to the P Bing Inspector of the City of San Jose
for a permit to install i u as1 i fe on the r"erse,side.
Exemption from roq ire t t aif Contractor's License is hereby claimed
by undersigned: owns statement filed ❑ ,
Undersigned attests that his }ata of California Contractor's. Licerqa
is in full force and eff6cf'and properly hori:es is a.fiiicV
San Jose City Business License #
f certify that in the performance of }hAwhi per if is i ued 0 shall not employ
any person in any manner so as to violate eewwor men's compensation laws ofCalifornia.
OWNER /7 Or-1 P2 .y i
ADDRESS of No.
ACE �SE��Fr�5�1�41t3��rFl�E
clicioL-v. # 231237 C•36, C•20 Signed ------------ ' -- bbl................................
2150 Stone Ave. San Jose, CA
(408) 297.81C9395 Bolli?ig6125 ace
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