4244853 Alderbrook
Building Permit Confirmed ❑
Not Required ' ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date - .... - - /_/ - 19./ .. P /j1m�)i+� N/]o.�. . ....z...Y
The undersigned ere s c io th� e� er�Il ctor of the City of San Jose
for a permit to insta a ec mcal r listed on he verse side.
Exemption from rag uirame for State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests the his State of California Contra cto's,Llcense
is in full force and effect erly auth ' es hi a pli
San Jose City Business $k
I certify that in the rf m ce of f"otl for rhich N, pe it is issued I shall not employ
any person in any manner so as to violate the workmen's compen lion laws of California.
OWNER
ADDRESS _(� 3 /�✓�Q�� Lo+ No.
USE OF BUILDING &:S BEN
Signed - _aYGI:. - ss °-
280120 (6 -73) r /
853 Alderbrook '�' C
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