83179 7542 Lockford
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
/�AP/,PLICATION FOR MECHANICA PERMIT
Date.l..a.Lyl----..__._2--�-------. 192-2—Pernnit No.----�3..1.._�...Ze
.........
Th. andarsignad horoby a PI sRSNSar r of }he City o Jose
for a permit to install the < o r '
Exemption from requirement fo State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑
TT r--
Undersigned attests that his State of Cali r ¢Contr nse1 �,�__
is in full force and effect and properly aufh �es q�is application.
San Jose City Business License #�(]�-4-4'�f��
I certify that in the performance o if he work for which this permit is issued I shall not employ
any person in any manner sg�as to violate the workmen's compensation laws of California.
OWNER_�c jr��[ /A
ADDRESS '7 yyy L�C`(���Lot No.
USE OF BUILDING_ L
Signed C�RLI.�Gl_
28
7 542 Lock,.'ford Gradon Htg.
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