19212854 BETTE AVE
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL
,1 PERMIT
Date...JJ _-......._........_. 19 --til_
Permit No............1� �...' ... Z .
_.-...............-
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
for a permit to install the mechanical work listed on the reverse side.
Exemption from requirement for State o California for Contractor's License is hereby claimed
by undersigned: as owner statement filed ❑
Undersigned attests that his State of California Contractor's License #
is in full force and effect and properly authorizes this application.
San Jose City Business License #
I 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 <2 0 1DQS-
ADDRESS 959 k�igitf i &Y � Lo+ No.
USE OF BUILDING Sin Ve
Signed...... 2k7a
280 Ark
5.9 BETTE AVE
m Z
A
O
2 .
_O
D
KL r
3
3
m
m
d
d
—
g
q
J m
v
'o
m
Z
a
H
7
m
O
n
Ix
A
II
O
2 .
_O
D
m
C
d
d
M1
g
q
J m
II