12283 O 69'BOLLINGER RD. ^
/v(/� Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
//��A,,P--P��L,�,ICATION FOR M// ECHANICAL PERMIT
Date-X11:Wi ...—f�......-------------- 19.16 Permit'No.__/�?7:�_�.-3------------------
The undersigned hereby makes ap lication fhe�r Plum bin nspec#or of the City of San Jose
for a permit to
install a ni a w is# op�tre e ide•
Evempiion from r r e ali is r ontractor's License i -hereby claimed
by undersigned: as owner ❑ statement filed @' /�N
Undersigned attests that his State of California Contractor's License # ,�n7Cr/
is in full force and effect a properly auth r' s this a Beef on.
San Jose Ci}y Business YYY"' Se #
I certify that in the pert m�m`5pp2e of the r k or hich is a it is issued I shall not employ
any person in any mann so aYto violate the workmen's compensation laws of California.
OWNER em�ler EhtP �ri5r�5 It1G.
ADDRESS-- �/ I Lot No._
USE OF BUILDING �
Signed -
zee-�zo le 7'31 80T oe z f:,eY;r IT1Mt; Co.
°r_75CBOLLINGER RD. . BOYER SHEET METAL & HFATTNIr
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