12225 7624 ELDERWOOD CT. ,
' Building Permit Con{irmad ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
$9-27-761Z7�2. S
Date................._................... 19-------. Permi{ No.. ..............------- -----..
The undersigned hereby makes applica1)on to the Plum �g�spactor of the City of San Jose
for a permit to install the m echegigl�ojk1ll 9�t a rse side.
Exemption from requirement far"Stafe�6I California for Contractor's License is hereby claimed
by undersigned: of owner ❑- statement filed ❑
Undersigned attests that his State of C6(iforria Contractor's License # 110828
is in full force and effect and properly aut�K(orrims this 'p/plic }'
San Jose City Business License # ( � 1 �'X/'
I certify that in the performance of the for whit this permit �: :ssued I shall not employ
any person in any menner so as to violate the workmen's compensation laws of California.
OWNER Ponri-
ADDRESS
76Q4 Eldenvood Ct Lot No. 2
USE OF'BUlWING Res
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6^i-A CARLOS SHEET MET�gn =�........_.._-
280-20(9-73) 779 OLD COUNTY ROAD _
7624C1A�5�5'CT LIFORNIA
SAN CARLOS SHEET MFTAI
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