8403635Q'BLACKWOOD
Building Permit Confirmed ❑
Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date ... (6 - _*7 _.. .... 9------ Permit I�Jn. ---- 7� 0 3
The undersign he ap r IuiT f�pec or of the City of San Jose
for a permit to ins the mac nical work listed on the reverse side.
Exemption from requirement for tete of California for Contractor's Lic nse—is—hereby claimed
by undersigned. as o r �J //J eta a fil
Undersigned attests that his Str f ornieyn> AVL;
/
is in full force and effect and pro y u oriaes iii{ 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 rawy—rskannarsso as to violate the workmen's corpensafion laws of California.
OWNER`_
ADDRESS
USE OF'I
280-20.!
Lot No.
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