2640 Building Permit Confirmed ❑
Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL2PE�R/M'IT
Date----_....-------------.-.// -3v --- 197:3.- Permit No.--...... 4.7-Q..----------
The undersigned h eby me I' ati �o/;WPI bi g Inspector of the City of San Jose
fora permit 4o inzi f rk ed rze side.
Exemption froAir Pre for State of California for Contractor's License is hereby claimed
by undersignod: es ownsQ �hfa ❑
Undersigned attests that his Stat al'for n f e Z 5 Z 37
is in full force and effect and propery a/u� crises this application.
San Jose City Business License # T y— 0/.3 Yy
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 az to violate the workmen's compensation laws of California.
OWNER—CA," P /3F`-(-, T)
ADDRESS Lot No.
USE OF BUILDING R�
��--�.G� S .P-.--�
zao-zo Signed--
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