6718 Mil P&rk �iii� Circie
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT.
APPLICATION
/FOR MECHANICAL/ PERMIT
Date 7..-GS......._.. 199-2�Pernni# No.--------".'-./../.(1-..-------------------
.
The undersigned hereby mekei'application,to the Plumbing,Gpector of the City of San Jose
for a permit to install'the mechanical work listed on'ihe'reverse-side.
Exemption from requirement for State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ �. statement filed- .vim
/_'L,:. 7"
Undersigned attests That his Slate of California�Confractor's'; ceme/#
is in full force and effect and properly',2u/thorixes fhis ap tic/ado7.
San Jose City Business License # ' /
I certify that in the performanceo{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.
OWNERS %�Jc�LF.ti
ADDRESS�_�� ��'� 1 /ca < Lot No.
USE OF BUILDING
Signed_.:. _✓L : -`L� ----------
280-20 ; /fil�Cfcso.0 co/v 97- ce ,
8123 Park Villa Circle Macson Const. Co.
Type of B.T.U. Remarks (Check V)
Appliance No. Input New Replace Relocate
Gas Ranges
Well Heaters
Boilers (Steam)
Boilers (Water)
Blower Furnaces
Suspended Units
Clothes Dryers
. 11
FEES
Appliance Fee
misc. Flues/Vents Fee
Flue/Vent /=f Hood/Ducts Fee
Hood/Duct Gas Piping Fee
Condensate Drain Cond. Drain
Permit Fee .Z
TOTAL FEE -e
INSPECTION RECORD
Ducts Underfloor
Ducts Complete
Flues in Wall
Flues Complete SC-1]- ]
Appliances/Misc.V-/]- 7J�
No. Gas Lines Outlets Size
Tested and Approved