105647544 KINGSBURY PLACE
CITY OF SAN JOSE
Building Permit Confirmed ❑
Not Required ❑
BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date ---------- "J^-.. ...... ----------- 19.-----. Permit No --------------------
The undersigned hereby akes application to the Plumbing Inspector of the City of San Jose
for a permit to install th a fi is is n t se
Exemption from req a w n or's License is hereby claimed
by undersigned: owner ❑ statement filed ❑
Undersigned attests that his State of California Contractor's License # %,, f3 7
is in full force ityd effect and properly aulhory�r7o_�/ �
San Jose Cit Business License CC''¢¢ �0
I certify that in the performance of the w6rk for which this permit is issuecri shall not, employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER .4—E.JELL-
TRAc7 Lot No.
J'96o ADDRESS S�f4 /e�,v�jt/laKc� ✓lL•
USE OF
2ee-20 (6-71)
7544 KINGSBURY PLACE CENTRAL SERVICE
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