8061 927 Rose Blossom dr. l /
Building Permit Confirmed f�
Not Required ❑
CITY OF SAN JOSE. BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date-......5e 1'--- --........_....... 197:r Permit No.----- --.. .._-----.....-----------
Theundersigned hereby ke} a I' f,
gn t e�Plu bip Inspect�[/. of the City of San Jose
for a permit to install the ss i fie evep �es�
Exemption from requv enf f�1$fate of Ca ifornia for-Contract.✓r's License is hereby claimed
by undersigned: as owner Z statement filed ❑
Undersigned attests that his State of California C tracto�rrs Licgns it
is in full force and effect and properly authorizes th��pKaetron.
San Jose City Business License # l.//
I certify that in the performance of the work for which this permit is issued 1 shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER Y E /`�AlCOG.C-
ADDRESSAQSC- 471-06SON/ 3je Lot No.
USE OF BUILDING—)!�!ESI�e N
Signed.. .
-- - -
280-20 o
927 Rose Blossom Drive owner
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