85143866 Bette Ave
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION
FOR MECHANICAL PERMIT
Date----------- --. !'k'41..----------
197,E Permit No . ............. C/....5—(-..-1-12
The undersign here y ek a 1' i mbj41 specfor the City of San Jose
for a permit to stall T e ec n' r ed on e r e sid
Exemption fr equir
or
o nia o Con ractors ;cense is hereby claimed
by undersigned: as owner statement filed ❑
Undersigned attests that his State
o California Contractor's License
is in full force and effect d properly
authorizes t' application.
San Jose City Businas Lia e � /�_
I certify that in the pe o
of }hew r p it '' iss ddj�ysh$II no} employ
any person m any mann so s t
violeie fh w rk's compensation laW� Calitorn ie.
OWNER r y4
�z
ADDRESS 6z-1
Lot No.
USE OF BUILDING
F,( %Q L`�7AC—
Signed ...... .... --------
2ao-20
866 Bette Gray
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