16506847 ALDERBROOK �(��/l/ /I�(i%%� ! r��� I Building Parm i} Confirmed ❑
�� Not Required �.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR. MECHANICAL PERMIT
Date .... :..L ..' ...... ....... .... ../19 ... errfi+ No. ....--I-`�..J -o'. ................. ---
The under gne a '£ ion 1 e bi ns ctor of the City of San Jose
for a permit t sta }h ec anica wo lisle o r n s,
Exemption from requi menT for S}afa of California For Contractor's Lice is hereby claimed
by undersigned: as owner ❑ statement filed �! /, /?
Undersigned attests that is fate of California Contractor's License # 7 7
is in full force and aifecf a pr ery au }ho'aes }h' a p'c lion. ,.
San Jose City Businessou annyS .{�
I certify that in th o me a of a is rm issued I shall not employ
any person in any manner so olate a workmen's c ensa}' n aws of California.
OWNER r/ /�G�S
ADDRESS
USE OF
C8ql %ALDERBR00K A & H HTG & A /c;
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