17274 7759 LILAC WAY
Building Permit ConfirmeA_2�
v l Not Required ❑
CITY OF SAN JOSE I BUILDING DEPARTMENT
A4.nd
TION F+O—R7 /PLLUMBINGcand/or GAS/ �PIPING PERMIT
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g red here makes a I' fio fo (urpbiy pecfor of the City of San Jose
fora permit to install m r pas e n e rovers. side.
Exemption'from re ' e e or o iforn a for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑n/,72 .
Undersigned attests that his State f California Contractor's License # L 5�-
is in full force and effect and prop as
San Jose City Business License
I certify that in the performance of the work for which } is permit i issued I shall not employ
any person in any�man ery�f'ope to violate th , wor en's compensation laws of'California.
yOWNER%1 7�! ag� �
ADDRESS 77 /LIa'C jl'7 Lo+ No.
USE OF BUILDING S
28030(9-73) Signed .. ;_ .--- -' - --- - ---
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7759 LILAC WAY �O�r�✓�L BOT. WELL�
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