11545 1144 ROLLINGDELL COURT
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date--------- ----.......g..... ---- -- - - 19.. .6 Permit N .//sy..s
.......................
The undersigned haby makfo a Plum ing Inspector of the City of Sen Jose
fora permit fo nista fh/e/ e h e rse side.
Exemption from vir of for tat¢ f a �forn.a or Contractor's License is hereby claimed
by undersigned: as owner ❑ femenf filed - , ,
Undersigned attests 1h e4 his State of Cal' o ontr i y�(7 J
is in full force and effect and properly ta�u,f izo,6 a plica ion.
San Jose City Business License #{' 7 .J
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 C/ L/
�11Lot No.
ADDRESS
USE OF BUILDING "�+'°`�' -,
280-20 (9-13) •E'j. r, p - _
1t44 ROLLINGDELL COURT WESTCO;INC.
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