10563 7515 MOLTZEN DRIVE
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
/ms73
Date------------�-....4--------------------.._ 197.6. Permit No.------ ------'----......----.....--------
The undersigned hereby, makes applitat' n } bin Inspector of the City of San'Jose
for a permit to install v a al o s} o r side.
Exemption from a or a of el' ontrac+or's License is hereby claimed
by undersigned: as owner ❑ s}atement filed ❑ _
Undersigned of+esis that his State of Caliry/�`nia nlracteJsis in full force and effect and properly auth4 la apao,
San Jose City Business License # 4 U I I
I certify that in the performance of fhe 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.
OWNER r�e,L1EL.L_
rr 7r/5— A I, 7'Z 6W 92' Lot No.
S-4 /Z
Sabo ADDRESS
USE OF BUILDING—
:'
280-20 (6.731
7515 MOLTZEN DRIVE CENTRAL US
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