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13345 8069 Hyanni5port Dr. Building Permit Confirmed ❑ Not Required ❑ CITY OF SAN JOSE BUILDING DEPARTMENT APPLICATIONFOR n ECHANICAL PERMIT Date-----..........................L- I- Q-._... 19�../.. Permit No. ..C....� for a he undiersigto ned htfie mtaehen calpwui4tl sled onh f^heli rbeise Inspector of the City of Sen Jose /inn4 i L - C` lI� y Exemption from requirement for Slate of Celiforma for Contra ctoh License is hereby claimed by undersigned: d as owner ❑ statement file,dy�❑��7, '/ Undersigned attests that his State Of C-al'Yornie Conifatf f,$ 0nJ.2a 4�4 �'Y� is in full force and effect and properly,Xuth�ies Ihis�ppl ice 100A" I San Jose City Business License # /��(7 0(. I certify that in the performance of The work for which thispermit is issued I shall not employ any person in any manner so as to violate the workmen's compensation laws of California. OWNER LTARY HUMPHRC-Y'S Q ADDRESS () E)9 H ye R) Lot No. USE OF BUILDING RESI DE O E Signed... 8069 Hyannisport Dr. Valley HeatiAO-404n Type of B.T.U. Remarks (Check V) Appliance No. Input New Replace Relocate Gas Ranges Wall Heaters Boilers (Steam) Boilers (Water) Blower Furnaces r riots ✓ Suspended Units Clothes Dryers FEES Appliance Fee misc. Flues/Vents Fee Flue/Vent Hood/Ducts Fee Hood/Duct Gas Piping Fee Condensate Drain Cond. Drain Permit Fee 01 00 TOTAL FEE Oa INSPECTION RECORD' Ducts Underfloor Ducts Complete Flues in Wall Flues Complete . Appliances/Misc. No. Gas Lines Outlets Size Tested and Approved