5815 949 Rose Blossom Dr:
Building Permit Confirmed
No{ Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APP ICATION FOR MECHANICAL PERMIT
Date---- —y? '----- ............. 191. Permit No................. ............
The undersigned here k p{llyrttioA }h P11'',u}},r96i g In3p���111Qr of the City of San Jose
fora permit {o ins}ell } do /r se sij
Exemption from requirement or State of ifornii or onf ors License is hereby claimed
by undersigned: as owner statement filed ❑
Undersigned attests that his State of California 9�onfrac{or's License #
is in full force and effect and properly authorizes is p- ica{ion
San Jose City Business License #
I certify that in the performance of the work for which this permit is issued I stall not employ
any person in anyTan 4r so as tviolate the workmen's
compensation laws of California.
OWNER, //f 1 Vl =�hl6�t� —✓ �GI%�LY
ADDRESS Lot No.
USE OF 'BUILDING
Signed...��� � f. ...... - .�......
280-20 (9-73)
949 Rose Blossom Dr. Murdoch
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