1543. 7654 Peach Blossom Dr/3,
Building Permit Confirmed E}— —
No} Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT .
APPLICATION FOR MECHANICAL PERMIT
Dates......L------- . 19.7,5 Permit No.--------------- _. ---------
The undersigned hereby akes applicetio }o ihej�Plumbing Insp�c}or of the City of San Jose
for a permit to install the machaniccal�workaliitod0 n-fhe�e'vaiie�id1.F'
Exemption from requirement forLSla}o of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ dy m'if'O",
Undersigned attests that his State of California Con}rectors L4c2e�#
is in full force and effect and properly authorizes this application. .� d
San Jose City Business License #
I certify }ha} 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.
OWNERLT�I�L/�C
yR 7655 /��i9ef�s�Lossori✓�-La+ No.
AD
' DRESS
BUILDING —
USE /L�-[�Ap//
.$igned..._.- ._. .....
280.20 Ib-73)
_-------
7W Peach Blossom Dr. Carolin Pools
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