10733 1190 RUPPEL PLACE
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR�7 /MECHANICAL PERMIT
Date.-S---ZS- 19/..SQ. Permit No.....---fa.7.33.... .......----
The undersigned hereb yyss pp ionii Pl bs^ n cc br of the City of San Jose
for a permit to 9nstall the �,pFL3yi�e1P 1fh1(d rulals4Sidi�
Exemption from requirement f.,/State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed pe C-1L0 c. 3
Undersigned attests that his State of California on? ;� s Li e , 11
is in full force and effect and properly autl7orixes T k ratio �(/
San Jose City Business License # L.+ (- " O b 6 3 S
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
ADDRESS *a 62 l r Lot No. 7
USE OF 'BUILDING Fes ,
Signed-----....6:F"tek----------!V61- ----- ---------
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lll {/ HUPPEL PLACE PARKER SHEET METAL
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