5248 7894 Fiesta mane
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
AP LICATION FOR MECHANICAL PERMIT
D fe.._ ?ersi-g-n-e'd
_ ....._ ./.................. 19. Permit No.-------- P. ..J.--'------------
Tha un hereb ma�a y ^io,/ilia mg ?specter of the City of San Jose
for a permit to ins}all iheLq�lodha "af-wrkk'isfed yor� re�ers�sida.
Exemption from requirement forr State of California for Contractor's License is hereby claimed
b undersigned: as owner /�/tem f {i€d q
y Undersigned attests that his State of C ifo7nia Contra tto"r's"L'ii _ _
is in full force and effect and properly authorizes this application.
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 inany an er so as to violate th' •workm n's compensation laws of California.
OWNER p
ADDRESS < C�Q� Lof No.
USE OF 'BUILDf G
Signed .. ... -- -- .... . . . _
280-20
r7A0A ri AQ+.-n I nn P.
Type of B.T.U. Remarks (Check V(
Appliance No. Input New Replace Relocate
Gas Ranges
Wall Heaters
Boilers ($faaml
Boilers (Wafer)
Blower Furnaces
SuspendedUnits
Clothes Dryers
FEES
Appliance Fee Q U�
Flues/Vents Fee
e/Vent Hood/Ducfs Fee
%d/Duct Gas Piping Fee . 3 O
ensafe Drain Cond. Drain
Permif Fee (,
1TOTAL FEE �lNSPECTIONREC0R0
1
Dr Inderfloor
Dudrs'Complete
Flues in Wall
Flues Complete
Appliances/Mist.
No. Gas Linese K f Outlets Size
Tested and Approved