12598 884 FERNGROVE ST. Building Permit Confirmed ❑
17 Not Required R
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date.��C....�.19ne1- /.-.'+...---- ----
197(. Pre mit tJo........_ �-.J.._. .--- - - -- -
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The undersi d hdreb� et ap cafir to"th f��lnspector of the City of San Jose
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for a permit to ins}all the mechanical work listed o iha_raverse si �J /
Exemption from requirement for State of CalyiMa for Ca -c�t.o•t n�s h eVy cl imed
by undersigned: as owner ❑ / v s a}ement filed /
Undersigned attests that his State of California Contractor's License #
is in full force and effect and properly�/uthori:as his a licatios.
San Jose City Business License #�`f 7 ��3
I certify that in the performance of tthe work for which this permit is issued I shall not employ
any person in any manner so as to viola}e the workmen's compensation laws of California.
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OWNER _ TC)1— 4I
J��� � AUyI S 7' f Lot No.
ADDRESS A o /
USE OF BUILDING �
Signed. -._... ..... .....
/ 4 pAAp ((gy�pp
884 FERNGROVE ST. JOHN S. PHILLIPS 2DDSTR4U�TION
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