10671 .7483 MOLTZEN DRIVE
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL /PERMIT
Date----` --..r..7...-------------------- 19'7b. Permit No...---- *7I
The undersigned hereby makes a plic ion t 9e Plumbing Inspector of the City of San Jose
for a permit to insfall�fhg�gs c lis nJJ//yye s side,
Exemption from u e or at
o C if6rd�fnira ctor's License is ereby claimed
y
by undersigned: as owner E] statement, filed Zr--],G q
Undersigned attests that his State of California Contractor's License # 2 7L/ 6 6
is in full force and effect and properly y}h as this pI ,at�io�/
San Jose City Business License # (LLJ��LY C)O 1JLd/?, l.�
I certify that in the performance of the work for which ipermit rued I shall not employ
any person in any manner so as to/vviolate the workmen's compensation laws of California.
OWNER r/PY/ P G/
ADDRESS 7LIC 3 /I/ olfzill, L2 Lot No.
USE OF 'BUILDING le- n
Signed -
280-20 (9-73)
7483 MOLTZEN DRIVE PARKER SHEET META1
y T T c <
"c0 01 m
� V• N. N N j � N j i w « = b � �
a 3 3 m
n N o — _
0
Z
d \7 y1
� z
m T
a m
> m 3
�• O T T T O -A Jr
oN N
� m m