10671 7507 MOLTZEN DRIVE
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPL/ICATION FOR MECHANICAL PERMIT
Date.-6-- /r�---- -------------------- 19.06n/... Pernni+ No......._._��..(r'..7/-----------............
The undersigned hereb makes a I' t' fo the PI bin Inspector of the City of San Jose
fora permit 4o install ih me al r ed�yTl� ' r pr"-onfride,
Exemption from ragor Sta o fd l or oniracfor's License is �oreby la ed
by undersigned: as owner ❑ sfafement.filod �y s-'�� -'N /7
Undersigned attests that his State of Cali //�� onfrac rs//��is n r7 669
is in full force and effect and properly auk', e Dap � �
San Jose Cify Business License # ���jjjjjj ����jjjjjj
I certify that in the performance of the work for which this permit is issued I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER
ADDRESS J�(7 7 o/ P.rc D r Lot No.
USE OF BUILDING eP`; •
Signed..._ ./✓// .. /- -
280-20 (9-13)
7507 MOLTZEN DRIVE PARKER SHEET METAL
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