24318 PHONE: 277T4581
1040 COLONY HILLS LANE Building Permit Confirmed ❑
Not Required --EL-1
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date. .................... ... 19.0.pp.0 Permit No... r�.k.J.� _._...._....-
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 of California for Contractor's License is hereby claimed r
by undersigned: as owner ❑ statement filed ❑ ^ R
Undersigned attests that his State of California Contractor's License # CS��
is in full force and effect and properly authorizes this application.
San Jose City Business License # 5^) -- (�
❑ 1 certify that in the performance of the work for which this permit is issued I shall not employ
any person. 11^^
Job Address )014G `iA 1 n . Lot No.
Owner 1P1lmE S �OTSD Tract No.
Permittee
USE OF BUILDING Signed .�_ ....
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1040 COLONY HILLS LANE VALLEY HEATING
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