17730 7740 OBSIDIAN CT.
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or_GAS`//PIPING PERMIT
Date-----'/-0- -I'�'------------------.---- 19.74 Permit No.------1'.77, 0
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The undersigned hereby Takes application to the Plumbing Inspector oQhe City of San Jose
Fora permit to install plumbing, fixiures and/o�pipes 14! oir t�SP rave side.
Exemption from requiremee�ntt/ or.�fefe.Qf�C�lifornievFnr Co raMor s.L'wense is hereby claimed
by undersigned: V P/raf owner ❑ statement filed ❑
Undersigned attests that his State of California Contractor's License #
is in full Force and effect and properly authe ixeg`t is applicatiioon/I
San Jose City Business License # �f Ix & ��pT
I certify that in the performance of the work for which this?,permit is issued I shell not employ
any person in any manna o as to violate the workmen's compensation laws of California.
OWNER
l
ADDRESS
y�740 Q +�jQ�Q��J�. Lot No.Lot No.
USE OF BUILDING
Codwf
GCQ D., iAG
280-30(9-73) /Signed ned -....--- -------------------- ---------------------------------...---� � �
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7740 OBSIDIAN CT: CENTRAL SERVICE
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