38687 (2) 7449 ROLLINGDELL DR LZI\ �nf,�"�,
P—KP4-7f( .( Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT
Date_....wev...... ----- ... I Permi+ No.... � ...Q.... ---------------
The undersigned hereby ma p sli n o t PI Ins or of the City of Sen Jose
for a permit to install plumb' q e r arse side.
Exemption from requirem or 'to o aliforma f r Conf or's License is hereby claimed
by undersigned: as owner ❑ sta}emonf filed 7�
Undersigned attests that his $tate of Cal iforni o tor's Lic se
is in full force end effect and properly authorize tZ �Q n.
San Jose City Business License #
I certify that in the performance of fhe work for which this permit is issued I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER )�22 ' 2!211Z )';>2 eZ,)
ADDRESS G y Ci Lot No.
USE OF BUILDING
Signed
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7449 ROLLINGDELL DR ACE
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