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15370 7592 HOLLANDERRY Y� �w��f�i47wr�f Building Permit Confirmed ❑ Not Required ❑ CITY OF SAN JOSE BUILDING DEPARTMENT APPLICATION FOR MECHANICAL PERMIT 370 Date...14v�__0(... 19 .7 Permit No..._... . ... ------..... The undersigned�er b ^rJ�yke�f ap lie t'o to th Plumbing-Isstpec}or of the City of San Jose for a permit to instdll r(dh3 lfs} o } r Jers4 sr e, Esemption from-fbQu �e far'St of-Cania f.r4rC- fractor's License is hereby claimed by undersigned: as owner statement filed ❑ Undersigned of}as}s that his State Ca rnia Contractor's License is in full force and effect and properly aLJlEofixas this apyli9afi9n ___ San Josa 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 woworkm/en's compensation laws of California. OWNER ��CL^ �E� ADDRESS 7 SAU t�_P�1_L�N��• Lot No. USE OF BUILDING F" Signed .. .------------ - ..................- 7592 HOLLANDFRRY OWNER 280-4o4n Type of B.T.U. Remarks (Check V) Appliance No. Input New Replace Relocate Gas Ranges Wall Hea#ars Boilers (Steam) Boilers )Water) Blower Furnaces Suspended Units Clothes Dryers G �— 00 FEES Appliance Fee Flues/Vents Fee Flue/Vent Hood/Duck Fee Hood/Duca Gas Piping Fee s �Q Condensate Drain Cenci. Drain Permit Fee o'7 c:-,_� TOTAL FEE INSPECTION RECORD Ducts Underfloor Ducts Complete Flues in Wall Flues Complete Appliances/Misc. No. Gas Lines Outlets Size Tested and Approved