24806 (2) 7573 SOLLINGER ROAD
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GASPIPING PERMIT
Date--------Nd-V- -------------------- 1974! Permit No.---o�7. !O( -- ---------------------
The undersigned her y a s A ti o m spector of the City of San Jose
for a permit +o install t p the reverse side.
Exemption from requirement r State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that his S+ +e ofCaliforni CC 1�en #—2/17
is in full force and effect and pro - fhorilOe a o�,
San Jose City Business Licens -11
I certify that in the performance of the work for which this permilf is issued I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER
ADDRESS _Z!
IXJ&I0A, Lo+ No. Lf
USE OF BUILDING16&SZZ;9mGQ-
-280-30(9-73) Signed ---- --
7573 BOLLINGER ROAD lllp�AC1'FICCM$CHArNyN�
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