15937881 Lily Ave
Q Z Building Permit Confirmed ❑
/ Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT7
Date ...................................... 9-27.. 19.%.7.. Permit No.---.._......./c4.c�L..3..G.....-----
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 License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned atfests that his State of California Contractor's License # 258540
is in full force and effect and properly authorizes this application.
San Jose City Business License # 48-00706
I certify that in tha performance of the work for which this permit is issued I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER William Thady
ADDRESS 881 Li 1 y Ave Cupertino 95014 Lot No.,
USE OF BUILDING Re jdPnCP
Signed ..� /.... ... In
----.................Valle Heati g
881 Lily Ave Y �
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