17722 I
7720 OROGRANDE PLACE
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
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Date-- -------1-o--1-- ------------------------
19.7. Permit No.---t-/-`-�-
7[---. �-------------------
The undersigned hereby makes application to the Pfum bin Inspector of the City of San Jose
for a permit to install IeumSi� fistures/..�/'ad or fl e}fr�}e on�tha reverse side.
Exemption from revirementlforr ate of�Cald ��Contractor's License is hereby claimed
by undersigned: W (� as owner ❑ statement filed ❑ t7/ rj
Undersigned d offs that his State of California Conheoapr�'s/Lice /se
is in full force any Usines and properly eut hojr'pe��fhio applitaiiq I'a y//✓
Sen Jose and
Business License ����� V
I certify that in the performance of the work for which this permit is issued I shall not employ
' any parson in any manner sg,as to violate the workmen's mpensation laws of California.
OWNER /✓J
ADDRESS 7 Zo PL, Lot No. i,:
USE OF BUILDING
Signed ---Cyy}: �QhpLCQ fiDa..9 G.-------
280-30'(9-731/ .\ ............ ....... -- -- .
7720. 0ROGRANDE PLACE. CENTRAL' SERVICE.
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