85195 7325 Fallenlea£
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
GyT
Date.../--- Z..�O.....:.... ......_.._ 1973. Pernni+ No. ..........( �_ .L- 7
The undersigned hereby makes,applicetion to the Plu ng Inspector of the City of San Jose
for a permit to install }�itg6jwp�k , �h v�¢verse side.
Exemption from requir for TPratee\ of Cadorrnnia For Contractor's License is hereby'claimed
by undersigned: as owne(4 ❑ statement filed Eg
Undersigned attests that his S}a}e aT a ifornia nir/�}off �Udgnse" �7 7 �U ll
is in Full force and effect and propedyixes t iso{p�Iiaf tYon, v/
San Jose City 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 F/jGGEt/ GE.9F SET '
ADDRESS Lot No.
USE OF BUILDING CONI
Signed G..D-S------G9TQS..... L6 ..H%6
28030
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