85444 1104 Milky Way
sv.a3 Building Permii Confirmad ❑
No4 Required ❑
CITY OF SAN JOSE � BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date _2-2.6-.'j3..._.... - .............. 19-:_.--. Permif No. - �-�-`1..y y- -
The undersigned h e a � h /riy/nbing Inspec}or of fhe Cify of $en Jose
{or e permi} fo instal t nice wor lis�e7 oTf 4hlrrevarse sida,
&iion 4rom reqwre n} {or $4a+a o{ Californie for Con#roctor's Licenze is Fereby cleimed �
by�undar�igned: ez ownar Q �� �+ e t i��
Undersignad ai}esfs #haf his $#e4a of Cal n a oni e
Iis in full force and effecf and proparly aufhorizes }his app icatian.
San Jose City Business Licanse #_�y_'j 06���
I cer}i(y that in ihe performenca of +he work for which fhis permi4 is issued I shell no} employ
any person in any manner so as To violafe fha workmen's compensa}ion laws of Celifornie.
OWNER Grover Drulev
ADDRESS 1101y Nilk� Wa�* Lo+ No.
USE OF BUILDING �esider.ce
Signed .. ._ . � - ......._... .. --
2H0-30 ptlas H_atir.g & Venti].ating Co.
1104 Milkv Gla A las
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