21330 936 to RTY COURT PHONE: 277-4581
Building Permit Confirmed
Not Required ❑
CITY OF SAN ,JOSE BUILDING DEPARTMENT . '
APPLICATION FORq
CHANICAL PERMIT
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Dafe._..........._S ... .T.............. 19.7L. Permit No......._.�..(..�J.3... .........
The und.r,i ned h�erae����'m a s tion ( !v ung or of the City of San Jose
for a permit }o 9insTellV v aP o X11: s I
permit
from requiraman or S}a a of Ca if rnia (or ontrecfor s License is hereby claimed
by undersigned: as owner` . I statement filed ❑
Undersigned attests that his State California Contra c}or's License #
is in full,force and effect and properl uT es }his Picafi
San Jose City Business License #
1 certify that in.the performance of The work For, which this permit.is issued I shall not amplq
any person in any manner so astoviolate the workmen's compensation laws of California.
OWNER nUJD rCCIf`7/
ADDRESS �V Lot No.
USE OF BUILDING g Z
Signed. ...... ... "
Icll
280-404N
930 'LIBERTY COURT OWNER
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