6387 8077 Hyannisport Drive
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date -------------------- 19.7 ... Permi+ No.----- `. 7
The undersigned hereby makes pplir,.efionf to };to,Plumbg,lnspeclor of the City of San Jose
for a permit to 'mfall f�re 7r 9a`ical iwph/ sled n ih G rse side.
Exemption from require of far Stafe o atSfor a for Contractor's License is herebyclaimed
by undersigned: as owner4ff statement filed ❑
Undersigned attests that his Statb of 0VTorn t fr6 or fjLicens
is in full force and effect and properly a hori:os this sap tic 11on!
Sen Jose City Business License 4
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�aJs�to violate the workmen's compensation lawsofCalifornia.
OWNER—1XZ—f L//'j_,)—/ JA/ C �/G�7 /v uAn jo�R�
ADDRESS gA! / �Zjt�✓01 i" ��T � ;=ot No.
USE OF BUILDING l:�6 I L
Signed.... - �4�
280-20 "
Qnr7r7 T7rovsni cnnrt Ai i VP Ri6k tan
Type of B.T.U. Remarks (Check V)
Appliance No. Input New Replace Relocate
Gas Ranges
Wall Heaters
Boilers (Steam(
Boilers (Water)
Blower Furnaces
Suspended Units
Clothes Dryers
�PY2 2,0 /
ui FEES
Appliance Fee p� ,A O
misc. Flues/Vents Fee a
Flue/Vent Hood/Ducts Fee
Hood/Duct Gas Piping Fee Q
Condensate Drain Cond. Drain
Permit Fee
TOTAL F O
INSPECTION RECORD
Ducts Underfloor
Ducts Complete
Flues in Wall
Flues Complete
Appliances/Misc.
No. Gas Lines,/Outlets—/— Size
Tested and Approved