3860 1110 Milky Way
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR M1 ECHANICAL PERMIT
Date--------- -d,(L.k.I....J1..... .. 19-14 Permit No........ V-----------------
The undersigned hereby ak appl' et' To (lumbi n actor of the City of San Jose
for a permit to install ih is or od n se a.
so from requ em f r o C lif rnia for ontrac}or's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that his State of liforni Contractor's License # ZSIVOSO
is in full force and effect and properly a —ri s this app' '�il��
San Jose City Business License #_ O It r�—
1 certify that in the performance of the work for which this permit is issued I shall not employ
any person in any ^w\nner so as to violate the workmen's compensation laws of California.
OWNER_�n_fL_�O_�.c,S_LL1cz�t l�
ADDRESS_�1 1_�'���k\\��p—L--Lot No.
USE OF BUILDING�E.SL[�EY��ti""L�,fr.. 1
Signeklur"-5if-e N- ---- ....coh--_ -------
260-20 \. KTc.\i.4R-
11.10 Milky Was Western A/C
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