10672 7484 KINGSBURY PLACE
Building Permit Confirmed ❑-
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date----5 J..gq/.................. -------- Id?-G.. Permit No.----------le( _77..:........
The undersigned hejeby makes application to the Plurn6ing Inspector of the City of San Jose
fora permit Fo insialrthe f�nib�alI xF Pisted Sn tR��vo'rse side.
Exemption from requirement for'S4 to ofrC.lif✓r`n,5 for'Contractor's License isreby claimed
by undersigned: f as owner [I statement. filed 67.0
Undersigned attests that his State of Califogia Contractor's License # _-A7y 6 6 of
is in full force and effect and 'properly authorizes this-app 1. 1. L
San Jose City Business License # L/ Et'.5 S''l//V {�%./�
I certify that in the performance of the work for which this permit is issued'I shall of employ
any person in any �manner so as to violate the workmen's compensation laws of California.
OWNER
ADDRESS 7 y y /� i 4' c b Len N d J . Lot No. 7
USE OF 'BUILDING ReS
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2B07ktf kINCSBURY PLACE, PARKER SHRRT METAL
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