97977373 FALLEN LEAF
Building Permit Confirmed
Not Required I ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR �jM�ECHANICAjLPEERMIT
Date --2--.....0 -----------'--..... 19.!v... Permit No..... `J... /.../ .....
The undersigned {areby makes_applicati0 to thepPI b' Inspector of the City of San Jose
for a permit fs inst9fl t jpfe/c/li�n> ��, id#ed
se
side,
Exemption fro req mrempnt or t to o aliforma for Contractors License is herebyclaimed
by undersigned: / as owner El statement filed � / %�
Undersigned 'attests that his Staf�f>p aliforni a'r s����'rrrttt6e`nse
is in full force and affect and propesly�W}horix¢ this glifc'S_ir(p.=
San Jose City Business License #yz C9
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 TFtOM E Ko zlo wS K/
ADDRESS 7?% 3 /"Py E N 1 e gF L�a,jLot No.
USE OF
Signed (,f..
280-20
7373 FALLEN LEAF B & B iiFAmrNr
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