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CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL
��/PERMIT
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Date........................ . ....... 19.).�Permit No....L...-- C-J_�...i- -----
The undersignodheraby makes application to the Plumbing Inspector of the City of San Jose
for a permit }o i ell yu���c c Y�or"'� e��d o �re. e side.
Exemption from er fftfi twS_ se rj a7drma� frac}or's License is hereby claimed
by undersigned: 7 as owner ❑ statement filed 113/
Undersigned afleststhat his Se of California Contractor's License #
is in full force and effect and p }�autho ixfs . ap 'catiom
San Jose City Business Licein
I certify that in the performance of f�r for w ich this permit is issued I shall not employ
any person in anymenr_o as to violate the workmen's compensation laws of California.
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OWNER qq� �'� y_
ADDRESS /_3 a / " ""`' Lot No.
USE OF BUILDING
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1329 STER LANE WESTCO HT &
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