34200 (2) 7758 ROBINDELLZ WAY
ai Building Permit Confirmed —❑
Not Required l�
CITY OF SAN JOSE 67 --�
BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
2- 7
Date................ . —07 ---.......------ 19?.p Permit No ------------------------
The
------------...._.The undersigned hereby m e e p' 'on f lu A pe of the City of San Jose
for a permit to insfell plum n OF li d v sa side.
Exemption from require en! or ate o al ornie or ontractor s License is hereby claimed
by undersigned: as wner Qr stafement filed ❑
Undersigned attests that his State of Celi(orn' onfractor's License #
is in full force and effect and properly authorizes Jhj/�`pplicafio ^ /�
San Jose City Business License # ttt/// (�
I certify that in the performance of the work for which this permit is issuecF I i1sall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER 4 e> 1 p�
ADDRESS 1>24-C /l0���1N� �� y Lot No.
USE OF BUILDING ('Si N �i
AV
00,
Signed......... �...............
280-401n
17758 ROBINDELL WAY OWNER _ . . .
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