11545 1136 ROLLINGDELL COURT
Building Permit. Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date........------------------------------- .-.-7-- 1974 Permit No..��,5�?�.--- - --------------
The undersigned hereb jn kes a lit o th_�e PIl�robing I ,�°�for of the City of San Jose
(ora permit 4o install t m h o�
Exemption from req e n r St a a of a i nw for o rectors License is hereby claimed
by undersigned: s owner El
Cann! statement filed / 1
Undersigned and
that his rStateoper of California racfor'o O /
is in full force and effect and properly aLu�t/hori es s a pl' o .
San Jose City Business License # 7
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 -�R• cam+`?"h�
ADDRESS / 3 6 q� C7Q Lot No. 15—
USE
USE OF BUILDING
Signed-1CL//Q -.-- �'�- ----------
280-20 (9-73)
1136 ROLLINGDELL COURT WESTC ' INC.
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