12225 7630 ELDERWOOD' CT.
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
2
Da+e.....- ..9-.22-.7..6........ --- .. 19...----- Permit No......._..�.Z..-----.....�.....------
The undersigned h by makes application to,the Plumbing Inspector of the City of San Jose
{ora permit 4o insf ih6%ehan�ee%Qrk}iiia o�� ra+ersa side.
Exemption fro require ani fat%$1 ate�of. NfoFni6-for Contractor's License is hereby claimed
by undersigned: as owner ,,� statement filed ❑
Undersigned attests that his State of Iirn a,faa91pa9Gv1Lcdna # 110828
is in full force and effect and properly au a i 4h fie fSlke4ron.�
San Jose City Business License
I certify that in the performance of the work for which this permit is issued I shall no+ employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER Pnnrt '
7630 E1delwood Ct. Lot No. 22
ADDRESS
Reser _
USE OF BUILDING
JAIJ CARLOS SHEE
779 OLD COUNTISI n
280-20 (9-73) SAN CARLOS, CALIFORNIA
7630. ELDERWOOD ,CT, SAN CARLOS SHFFT METAL
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