NO PERMIT NUMBER 1121 n0LLTNnELL COURT
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date-------------------/G. .....1 ...... 19..7bPermi+ No.__........---------------------------..._...
The undersigned hereby pp n t lum�b'D,g.l p r of the City of San Jose
for a permit to ins{all
the �jl�rk� 6 e fvpFs iz
Exemption from requirement for Cafe of California for Contractor's License is Hereby claimed
by undersigned: as owner ❑ statement filed
Undersigned attests the+ his State of Cali r ntra s/�i v��
is in full force and effect and properly autho xes hfi ay� iMfrf
San Jose City Business License / —�0�,'�S'�
I certify that 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.
OWNER �� 'y- e �ae�ST
---/_!_�-� /y� / ey, Lot No.
ADDRESS9
USE OF BUILDING S/meq 'mac S
Signed.....A-& 1 VALLEY.PLU.l19J1!N.G------ - -------
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RnT.i,TNGT)FLT, Cf1iTRT P. C.'&PTOVAi,I.-:YSikPTA CLARA, CALII
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