20532 6664 CLTVV6PU COtt> T PHONE: 2]]-4SB1
Building Permit Confirmed ❑�_
Not Required - ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
. Date.... .... .--- ....P . ..-........ 19.7 .. Permit No. ...0_ _ ...� ...
The undersigned hereby makes application to the Plumbing Inspecfor of the City of San Jose
for a permit to install the mechanical work listed on the reverse side.
Exemption from requirement for State of PQ1�irirI'fori for Contractor's License is hereby claimed
by undersigned: as ow k statement filed ❑
Undersigned attests that his State of Calif nia 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 y��S��D/�' �k - �Qf/'�✓
ADDRESS �^��� ( LiFFr�oE�-y (� �. Lot No.
USE OF BUILDING
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280-404N
6664 CLIFFORD COURT OWNER
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