19321 7915
AYrC9 � 'v'.fvY-A-Ta'y
J Building Permit Confirmed ❑
--� Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FORCHANICA/L/ PERMIT
Da+e......� -:.. _y............... ....... l9�.�ernnit No...._Af?,—(--- ----........._..
The undersigned heeby makes application to the,Plumbing Inspector of the City of San Jose
for a permit to instal th�jrrL'ch j'�1w3Lk7Gs}�� e��arsa side.
Exemption from ire^_J^/n+ fo •, ate of/California for Contractor's License is hereby claimed
by undersigned: / as owner ❑ n stntema 4 filed ❑
Undersigned attests that his Stat�ef Celifo /� / G .�� �l .�
rh CoRire c}or's�Lieensa # JCI ;Y/C/ 5
is in full force end effect and propeil{`euThofiaf Ws application.
San Jose
Cit
Business License
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 as to violate the workmen's compensation laws of California.
OWNER
ADDRESS 7r�/��--�� PJ2 4�/ Lot No.
USE OF BUILDING�/ti -'
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