24807 (2) 7581 BOLLINGER
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS
�PIPING PERMIT
Date-----/VoV.------------------------- 19-7-6 Permit No.-----o--`-7.! ro. --'7........-*---------
The undersigned hereby kes epplicetion to the Plu[(((((n�����bing Inspector of the City of San Jose
for a permit to insfell plum in f to p isjrd on 4 verse side. -
Exemption from require n { r o sLicansa is hereby claimed
by undersigned: as o ar ❑ statement filed ❑
Undersigned attests that his S4a+e of California Contractor's License #''--3,/-2-773 I
is in full force and effect and properlyuthoriaes this application.
San Jose City Business License # /3 7
- I certify that in the performance of a for whi i or is ss l all not employ
any person in any manner so as to violet a or men's o b a s dfVCal nia.
OWNER_Q� iv
ADDRESS 461 19or- Lot No. Z
USE OF BUILDING 5��
280-30(9-73) \ Signed ......
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7581 BOLLINGER PACIFJVC'MECHANICAL
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