34192 7758 ROBINDELL' WAY y_
Building Permit Confirmed ❑ p
No} Required ;J--� yv
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GA`S�PIPING PERMIT
Dafe_.�.. /.-A.... ------------------- 19» Permit No.--- / =(PI`C lj-;-�-----.....----
The undersigned hereby mak application to the Plumbing,Inepee} of the City of San Jose
for a permit }o install plumbin {' u s o li n e rse side.
Exemption from requirame i r r t } s License is hereby claimed
by undersignerl: as own M- sta}amen} filed ❑
Undersigned attests fhaf his State of California Co ors License #
is in full force and effect and properly authorizes this a p jon. 1 '
San Jose City Business License # 5 0y�Lu
I certify that in the performance of the work for which this permit is issued I sKall not employ
any person in any manner so as to v'iolate the workmen's compensation laws of California.la
OWNER c7/ Z / Co �e /
ADDRESS % S� /I ob/ G(/ Lot No.
USE,OF BUILDING of l
Signed...... /. -_._........
280-401n .
17758 RQBINDcLAL WAY OWNFR
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