8986 (2) 7770 Oro Grande Place
Building Permit Confirmed ❑
Not Required ❑
CITY OF. SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date-------------1.2x.-3-75................... 19----.... Permit No...........C -Qrt -.-...--------...-
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
for a permit 4o install'the�/mechamcal2work lis}'ed dn'the reverse side
Exemption from req uiremenT for S}a4a o4�Cdlifornie ef'Z actor's Liconse is hereby claimed
by undersigned: V as owner ❑ statement filed ❑
Undersigned'attests that his State of California}Contractor's License # 11082
is in full force and effect and properly authorizes 4hij)e'plica}ion. /�]
San Jose City Business License # 464060"69��� 5 J-7
1 certify that in the performance of the 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 -
Ponderosa-ADDRESS 7770 Orogrande Pl Lot Not_
USE OF BUILDING [ R#S `� c
SAN CARLOS SHEET IAL-Y�`n'
.
779 OLD COU!'�TY
ROA tgigned.-. ...- Gv.�--.-----.--
280-20 (6.73)SAN CA3LOS, CAOFO.trdA
7770 Oro Grande. Place san Carlos s/m
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