17723 7760 OROGRANDE PLACE .
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS`7PIPING PERMIT
Dat e-----------�-0'--/7------------------------- 197J. Permit No-----4. /./.,
--------------"---------
'The undersigned hereby makes applicatii0 to fha lymbing IPspector of the City of San Jose
for a permit to install plu r'r .g�,i r den 12% pi s lis Jd X reverse side.
Exemption from ra�uirKent%for S��Callfornia foroContrractor's License is hereby claimed
by undersigned: / as owner ❑ statement filed ❑ /7/.L rl /
Undersigned attests that his State of Califordja�Contrector's License #'
is,in full force and effect and properly authorixaz�thls applicatio b
San Jose City Business License
I certify that in the performance of the work for which this permit is issued I shell not employ
any person in any manner sJ�s to Aolafe the workmen's compensation laws of California.
OWNER
ADDRESS -171,00 D 1"L Lot No.�f
USE OF BUILDING
_�-L- -' cahvica /lv., 9ytc.
280-30.19.731 Signed ......cR�Ull-------
.off ...........lt.----"---------'-----
7760 OROGRANDE PLACE CENTRAL SERVICE
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