12264 1-486 JAMESTOWN DR.
v Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL
l PERMIT
Date...............10-6........-..._........_. 19..76. Permit No�_-I/-2.--' ---r-------....----
Tha undersigned hereby s� ppli fioN t�fs Pylu�inQ specfor of the City of San Jose
for a permit to install f`6 j�cF ni��k Vedd,. "i mss Cide.
Exemption from requirement or State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filri_58540
Undersigned a}}¢ifs that his St11-e of Aliformp�reso rac dr L'�nse
V
is in full force and effect and pre
Ahorixe(t�ii��ppx tion.
San Jose City Business License # � 00012
1 certify that in }he performance of the work for which this permit is issued I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER William G. Clute
ADDRESS 1486 Jamestown Drive Lot. No.
'USE OFrBUILDING Residence I J n // —p
Signed.....Ual(2 ✓✓ --�1�� " �----.......--
zeo-zo (6-73)
1486 JAMESTOWN DR. VALLEY HTG.
Type of B.T.U. Remarks (Check V(
Appliance No. Input New Replace Relocate
Gas Ranges
Well Heaters
Boilers (Steam)
Boilers (Wafer)
Blower Furnaces /OQ�7'I i/
Suspended Units
Clothes Dryers
FEES
Appliance Fee 2 . 00
Flues/Vents Fee
Flue/Veno Hood/Ducts Fee
Hood/Duct Gas Piping Fee
Condensate Drain Cond. Drain
Permit Fee -2100
TOTAL FEE .00
INSPECTION RECORD
Ducts Underfloor
Duch Complete
Flues in Wall
r
Flues Complete
Appliances/Misc.
No. Gas Lines Ouflefs Size
Tested and Approved