177197712 OROGRANDE PLACE
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PII/PIIN/G PERMIT
Date - %19 .x.. Permit No. /-/--/`------------------
-------------------------------------The undersigned IJee�y r2akcs,pp,icatjon #o th Plumb'ng�spactor of the City of Sen Jose
Fora permit to install tumbm 'fixfures%pd%o�r(-IPe ti d/on Nie reverse side.
Exemption From regmrem n4 for Sfe a of CSifor a for Con#rector:s License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that his State of Calif FG n1, ofor's License # / 7447 7
is in full force and effect and properly eu}h�i�s,#hiR)W��i1on� �(��
San Jose City Business License # ii �A
I certify that in the performance of the work for which this permit is issued all not employ
any person in any manner to as to violate the workmen's compensation laws of California.
OWNER 9
ADDRESS '711 i Dit..e-c PLy Lof No.
USE OF BUILDING 11 t`-' c_.,. /�
280-30 (9-73) \ l Signed-.....CR/1— --- ---d�!�W ,�Q.t-.Y/'1.�.-----
7712 OROGRANDE PLACE.. 'CENTRAL SERVICE
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