24807 7565 BOLLINGER .ROAD
. . Building Permit Confirmed ❑
No+ Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date....... Qv .------------'--- -- 19-7(o Permit No....._.�r--..y0..o7---------------------
The undersigned here makes applicatio tg}Ite Plumb spac+or of }he Ci}y of San Jose
for a permit to install n {i r pgI tae reverse side.
Exemption from re ui } o i r e r rector's License is hereby claimed
by undersigned: owner ❑ statement filed ❑
Undersigned a+tests•thaf his tt.f, of California Contractor's License
is in full force and effect and properly au orixe i 's applicatio
San Jose City Business License #
I certify that in the performance of wo or which fhi permit is issued I s no+ employ -
any person in any manner so as,to viola a the workmen's compensation laws of California.
OWNER st"reg"e't
ADDRESS 7S�S /..,6t,e,�'p Lot No.
USE OF BUILDING ` G
280-30(9-13) Signed ...... �l
7565. BOLLINGER ROAD YHL I/r'1C�MECHA�I�
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