10563 7493 MOLTZEN DRIVE
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
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Date----_....----c�...-./----------------- 1976_ Permit No...---- ------------------------.....-----
The undersigned here eke p is 'qqn to if Inspector of the City of San Jose
fora permit 4o install } e i fste a er a side.
Exemption from re tram for S} }e I ornia ?Fe
License is hereby claimed
by undersigned: as owner ❑ statement filed ❑ /7/S�
Undersigned attests that his State of C/ o Coonnfrp{•,c}ors i ens
is in full force and affect and properly aJ% }hi'r%'v 1'
San Joie City Business License #
1 certify that in the performance of the work for which this permit is issued 1 shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
TCACY OWNER 1 2 a N ELC.
ADDRESS 74 q 2+I o I T?EN 04 , Lot No. 9
USE OF BUILDING-
Signed
UILDING Signed-------- -----------------------------
280-20
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280-20
16-73)
7493 MOLTZEN DRIVE CENTRAL SERVICE
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