248067561 ' BOLLINGER
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Rate ----- yQ.✓...... ------------------------ 19.7k Permit No. .... +--*94 --------------------
Tha undersigned hereby ekes app' ti t he bi g p for of }ha City of San Jose
fora permit to install plu in f' u s / ipaeverse side.
Exemption from requi tate o a r i for Contractor's License is hereby claimed
by undersigned: a owner ❑ statement filed ❑
Undersigned attests that his State of C 'fornia Contractor's License.# '2_1 �'—
is in full force and effect and properly auth es 'n ePplica }Rn.
San Jose City Business License #
I certify that in the performance of the work or which this permit is iswegKI shell not employ
any person in any manner so as to violate the workmen's compensation laws of California.
�% O``W NER �J�, a �.
�" S�ADDRESS,p�r_�y0 Lot No.
USE OF BUILDING
280-30 (9-73)I Signed .._---.... .�/M.. ... .. - -'------
F�i¢cif-�c NJ�c ic�v-L
-_"7561 BOLLINGER PACIFIC MECHANIC L
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