854437415 Plum Blossom Drive
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date y.. 7 -...
---.._----....------------------ 19 --permit No. ---V ...
The undersigned hereby makes application to the Plumbing Inspector -of the City of San Jose
{ora permit to install The mechanical ` ork lis#ed n�ihe reversej,Lide�
Cant t io // c r' / ��
Exemption from requirement for Stato of California for Con}rac#or's License is hereby claimed
by undersigned: ai owner ❑ statement filed ❑
Undersigned attests that his State of California Contractor's
r's Li License
is in full force and effect and properly uuthorizes /#yhis a ma#i�i
San Jose City Business License # ter_Qa0o I "` 1 / I /1
I certify that in the performance of the work for which this permit is issued I'shall not employ
any person in anyfrmrner so as to viol!�e the workmen's compensation laws of California. A
OWNER _
ADDRESS ��47Y� /!%1 4 Lot No.
USE OF BUILDING /l,/-�_ V-72�
Signed ---- COUNTY SHEFT METAL
150-XijiTH FiHkRTSON
280-30 CAMPBE;�6 IF(RRP�IA
7415 Plum Blossom Dr
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