28611 7750 Ok0 GRANDE PL
Building Permit Confirmed.B�
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING
PERMIT
Date------ .. ._.Z.�.................. 19.. �.y
..1.. Wernnit Ncs....,,r-.�....�.E...{
.....................
The undersigned hereby makes application to the�P.1 Ebina Inspector of the City of San Jose
fore permit io install plumbing �xturj gA%pr pi�s�listed �tf r'p�z'erza side.
Exemption from raquire�n4�fo1 a�fa^1e Yaf7Cornie for Contractors License is hereby claimed
by undersigned: as`6wnar ❑ statement filed ❑
Undersigned attests that his State of Cal ifornj asContracto�,License # -Z—
is in full force and effect and properly a hp rizesythisfipplicattA f
San Jose City Business License # �f -7 oi/ Q t LI �
1 certify that in the performance of the work for which this permit is issued I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER M(KIZ NZOCTOI?
ADDRESS77. QX 0 6;ZAA146 kL . Lot No.
USE OF BUILDING s W 144 P6 n
CSigned ... . _---- -..-.....----...:--..............--..
1 280-,40111
7750 ORO GRANDE PL
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