12225 7648 ELDERWOOD CT.
Building Permit Confirmed ❑
Not Required ❑
_ CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
9-27-7619Permit No. -..�.22 ._...
Date-------------.........1-. ...._............... .. -
The undersigned hereby makes appli.a}ion to the Plumbing Inspector of the City of San Jose
{ora permit } hp�yyEe Nb ,yted/6a reverse side.
Exemption irorsf�r��,jKerffZfo e/.f'�a if b n/ia for Contractor's License is hereby claimed
by undersigned: �� as owner ❑ statement filed ❑
Undersigned attests that his State of tho�ile his appfic 1lcff�/�r�}�, .._._
is in full force and effect and properly C.Iifc,e> s araq.Uo�(l/ ✓San Jose Jose City Business License # 47-00361
1 certify that in }he performance of the work for which this permit is issued I shall not employ
any person in any manner so as to violate the workman's compensation laws of California.'
OWNER Pond. HoMbS
. ADDRESS
7648 Elderwood Ct. Lot No. 19
USE OF 'BUILDING Res..
b,rl CARLOS SHEET MEJALn V4 .-......f.------- �
q ----...............—"----
280-20 (9-73) 779 OLD COUN7Q ROAD
SA N��ARL-T, CALIFORNIA
7648 ELDI`K� DCS. . SAN CARLOS SHFFT MFTAI
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