24807 (2) f -
7569 BOLLINGER ROAD
Building Permit Confirmed ❑
_ Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date.... 0–QY.. --------------- A
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- ---.. 19.7( Permi+ No.....rt
The undersigned here m es pp ica}i } the Pum ng Inspector of the City of Sen Jose
for a permit }o install p mb' t s e ist t r erre side.
Exemption from raqu ale ra is License is hereby claimed
by undersigned: owner ❑ s}a ement filed ❑
Undersigned attests that his State of alifornia Contractor's License #r_J-/_�F-7J�
is in full force and effect and properly au riz his appli do
San Jose City Business License # J.
I certify that in the performance of a wo or w ich this permit isse
shell not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER 49—AW�l
ADDRESS
7-5,6.9 143cz j� Lot No. S
USE OF BUILDING 4 e-ft-C'e-
280-30 (9-73) l Signed At
7569 BOLLINGER ROAD FTC—fCIIANI 7aL
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