10740 1224 RUPPELL PLACE
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PE'R�7M7IT
Date------------ 7 6 w._7�V-------------------
The
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.. ..�..._:......-------... 19.7_._ Permit No.------ --
The undersigned hereby makes app cation to the Plumbing Inspector of the City of San Jose
for a permit to install the mechanicalApr I-
Exemption
Exemp}ion from requirement for m } c icense is hereby claimed
by undersigned: as owner s}e}ement filed ❑
Undersigned attests that his State of California Contractor's License # J7/ r3 7
is in full force and effect and properly authori f pplice}i
San Jose City Business License # / /Z
I certify that in the performance of the work for which thli permif is issued I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER
f�f
ADDRESS I ZZ Lot No.D f�
USE OF BUILDING x
Signed---C 14t`46il-5a1[ lia-cO.,-9�-------
280-20 (673)
1224 RUPPELL PLACE CENTRAL
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