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Bmliling'Permi} Confirmed ❑
SPY'• �� � Not Requiied ❑
CITY 6F JOSE BUILDING DEPARTMENT
GAPPL�IJCATION FOR MECHANICAL�/PERMIT
Date Sof'-.1..:.. �Q.........._.. 19.y.1..7pPermit No..__..pC..f....(P.d.f/r----:--
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
for a permit to install the mechanical work listed on the reverse side.
Exemption from requirement for State of California for Contractor's,Lice,: is hereby claimed
. ,by undersigned: as owner 11 statement
filed
Undersigned attests that his State of California Contractor's License $k
is in full force and effect and properly a �rees this^a ppI c8,n
San Jose City Business Licensey— f
I certify that in the performance of the work for which this permit is issued I shall not employ
any person in any manner manner so as to violate the workman's compensation laws of California.
OWNER
ADDRESS l)� I 'nTV' ) y�J Lot No.
USE OF BUILDING
Signed. ..........
REDMOND PLUMBIftao4n
877 LILY AVENUE
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