11545 1129 ROLLINGDELL COURT
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
O--'.�1........-- --- 19�.Ea-. Permit No. /S�'s'
Date---------- ---- ........ --.. ...-
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The undersigned hereby���fff^^^akes a a4io 4 e Plumbin Insp for of the City of San Jose
{ora permit
to ins#all th n re .
Exemption from ragm 2.51K"{ Sfa}e of California or Contractors License is hereby claimed
by undersigned: as own ofr statement # ❑ _ 7 4/b
Undersigned attests that his 54a}e of a uta Con c',tao�r's� ices
is in full force and effect and properly L�eq es this pyrcn�
San Jose City Business License # 77 ' 0 3 � :4
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 tviolate the workmen's compensation laws of California.
ADDRESS �I % P'Ci�- - rifXl:fA L// Lot No.�
USE OF BUILDING
Signed.[.<�--4.17 2-... ,: .....---
280-20 (9-73) AX
1129 ROLLINGDELL COURT WESTCO INC.
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