115451105 ROLLINGDELL COURT
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date --- .----- ........4..:.--`{ .............-.....- 19_7..45 Permit No. ----// Syr '..----.:....----
The undersigned hereby ekes applica}ion to +he Plumbin Inspect of }he Ci}y of San Jose
for a permit +o insfel ih mac t, li �gyihe v std
Exemption from req 're en e o C ifo i f o c s License is hereby claimed
by undersigned: as Aner ❑ statement filed ❑
Undersigned attests that his State of California Contractor's License # ylo7
is in full force and effect and properly taufhori:es ap ioation
San Jose City Business License �$ �• �'(� /(//v4/�.Gw
I certify that in the performance of the work 4or 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.
OWNER
ADDRESS �� d �!%"� "' r2�L/' Lot No.z/
USE OF'BUILDING
�/ �X M A r
Signed .i^:,r r.... ---1'------------- -_-------
280-20 (9-73)
1105 ROLLINGDELL COURT VVV WESTCO INC.
Z
0
0