10740 1186 RUPPELL PLACE
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date..........s /?-.._--......- ....__.... 191_6. Permit No.-----/0--7-4#V ------------
undersigned hereby ke ice 'on t Plu bi pecfor of the City of San Jose
for a permit to install 4haCk�� u��/t�` J � e.
Exemption from requirement r State of Cali ornia for Con}racior's License is hereby claimed
by undersigned: as owner ❑ statement filed
Undersigned attests that his State of Celifi?r n}ra L' IQs✓ 7� r-�
is in full force and effect and properly au4hdri,/ ^''aP
San Jose City Business License # 4 Q
I certify that in the performance of the work for which this permit is issued I shell not employ
any person in any manner so as to violate the workmen's compensation laws of California.
���— OWNER
`J
4d,Q - ADDRESSt (Y�o /Gid//1a� ��✓ Lot No. (o
USE OF BUILDING
('oytt-icc!�-oiwic,e
Signed - --------
280-20 (6.73)
1186 RUPPELL PLACE CENTRAL
m Z D T T O D 0 2 T (7 m mm o
o _0c c c c o o c o c ° ° o
N ^ N < m R N N N
°-
-
v
0
d H O
T t
Z
N
n m L N
� S
^
a