17718 (2) 7756 OROGRANDE. PLAC E
- Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
/Date----------- --------------------- :.._..- .. 197,)77'Permit No. -`7-71.9--------------
The undersigned hereby makes appplication {etrg Plumbing Inspector of the City of San Jose
fora permit to inste I plflmbi/{{ng�fix/Br �d/or a li f il' n the reverse side.
p J/Y.N /P4"��� yPlfia fJ
Exemption from regouam n4 foN t6}a of Celifo nie for Contractor's License is herebyclaimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that his State of Califf or'ia!!Contre tor's���!!!Li nse
is in full force and effect and properly eufhoji3a'z hisrappJ i VIA0
Sen Jose City Business License # V. /- Y
I certify that in the performance of the work for which this permitis iss ed I shall not employ
any person in any manner 5o fo viollla#e the workm
en's co7ensation laws of California.
OWNER F
ADDRESS -7 7 D yL, Lot No.
USE OF BUILDING
280-3019-73)
1 Signed -----CJl/Zt/1Q1 oW{w.GCR-_�D.�-9KC------
7756 ,OROGRANDE PLACE , CENTRAL SERVICE ,
\ in CNS T _O• ONC W * E
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