17435 (2) 7586 Normandy Way
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS/PIPING PERMIT
Date.. .. V ------ -- ------------
- 19�ernnit No.------{-7—`1--3--5`._.._-----
Tha undersigned hereby rrnakq ste p?e9ti�i}o?A*6 ♦,lombingt In Rc`fLr of the City of Sen Jose
for a permit to install plu bf'gyf�ei an`�e �ip�e�Iistpy&f r reverse side.
Exemption from ragm ren for/.64eie of alifornia for Contractor's License is hereby claimed
by undersigned: as®owner ❑ statement filed G
Undersigned attests that his State of a lifornia!ContrWo f� Licen e O
' is in full force and effect and properly
a
a 4 saes this a lie i n.�
San Joe City Business License#
I 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
ADDRESS 1 SL(� /Qn�/9�1 7 1/ t� Lot No.
USE OF BUILDING
280-30(9-73) Signed -- C-I ------------------
7586
------------7586 Normandy Way Ace
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