10564 7492 XTNa9E;U2Y PLACE
Building Permit Confirmed ❑
1 Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
rr-77
Date-------------_.�-_-4-------------------.. 1976-- Permit No.-----/-d -- -------------------
The undersigned hereW� Wwe .
iha bi gJrrypector of the City of San Jose
for,a permit fc install theo y r e.r Eaempiion from requii{ rniafor Contractor's License is hereby claimed
by undersigned: r ❑ statement filed ❑
Undersigned attests that his State of lifornia Contractor's License # /7/J f
is in full force and Beffectusiness
and properly bihiz I' a V
" Sen Jose City Business Li<enza .�}' y�(�
I certify that in the performance of the work for which this p�issued I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER 2FnfELL
T�+LT ADDRESS 74 5 L Ie/N S tsu2N OL Lot No. (o
j4%0 nn y
11 USE OF BUILDING 'CE� '
Signed---- !Gi.--:�21xJJ!-CC-_�JJ..-_n12C,--...-
280-20 (6-731
7492 KINGSBURY PLACE CENTRAL SERVICE
Z D m T 0 O
o v c c c c o o — o
c o 0 o s
0
O p + o
v � � m o
CL
c
z
70 v a G1 S T D
m '3 o
m
N m