17722 (2) 7774 OROGRANDE PLACE
.Building Permit Confirmed ❑
i Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date....---- G "/7...---------------.-------- 197sE... Permit No.--.... _.. -- ---------------
The undersigned her b�fakes epprlicati4n to the Plum bing,lgspector of the City of San Jose
fora permit to install lb us,bin �fl,�tur�'��nd/oza apes'listed ��the reverse side.
Exemption from regi irementf o{i State ebf•Colifornia�for Gonirac4or's License is hereby claimed
by undersigned: ® as owner ❑ statement filed ❑ J7/J,.��
Undersigned attests that his State of Califorr feii Contractor's License
is in full force and and properly authorizes ihiarappli. cafi6
San Jose City Business
s License
I certify the+ in the performance of the work for which this permit is issued frshall not employ
any person in any mann so as to violate the workmen's compensation laws of California.
OWNER
ADDRESS 7774 Q � r Lot No.
USE OF BUILDING
280-30(9-73) I Signed-------' ? oi¢/t[1l,G?.�O,�.Spm..._.
7774 OROGRANDE PLACE , CENTRAL SERVICE
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