17576 7917 RAINBOW DR
' Building Permit Confirmed/
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date........../�-:"1...I......2.4�n......... 19'74.. Permit No......... ................
The undersigned hereby a es ap li-afion to fh Plumbing In ctor of the City of Sen Jose
for a permit to install the c o o r rs id
Exemption t from req r e o o actor's License is hereby claimed
by undersigned: s owner statement filed ❑
Undersigned attests that his State of C ifornia Contractor's License #
is in full force and effect and properly au j ortio� / ��•
San Jose City Business License #
I certify that in the performance of the work for which this permit is .ss�l shall net,,,yyym plo���yyy
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER c �a-f s �` 7 fkt '
ADDRESS 75/7 V� C�K2 Lot No.
USE OF BUILDING 5fr 4 rCS/ nc
Signed---....... 9 f^ .....- - ........ 1 - ... ._..
280-4o4n
7917 RAINBOW DR OWNER
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