10733 1198 RUPPEL PLACE
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL nnPERMIIT
Date-5-- ?15-.- ...............__......... 190..6.. Permit No-----....-.L.S/..7>3J..._-------
The undersigned hereby es c e PI ing sp�f the City of San Jose
for a permit fo ms#all the y! on f re ry ✓
Esemp#ion from requiremen} f Sfafe o Ca iforn a for Contractor's License hereby claimed 7
by undersigned: as owner [I statement filed L�
_,E
6y S'C�'"� 7
Undersigned attests that his State of California nlrac#or' .lw r
is in full force and effect and properly`authorix�jsi is a'ppi /(///
San Jose City Business License # —f 6— V
1 certify that in the performance of the work for which this permit is issued I shall no# employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER <f`erieI/
ADDRESS I/ 9JL L �teP �� / Lot No. R
USE OF -BUILDING
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