10740 1228 RUPPELL PLACE
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date.- -- `�/ -----...------ 197 Permit No.--------- ®7TU-----------------
The undersigned hereby ke a plicafio o the Plumbing Inspector of the City of San Jose
for a permit to install the ch i ike �s 'de /�
Exemption from requir n a a o alt r id�r o cf��(icense is hereby claimed
by undersigned: as wner ❑ statement filed ❑
Undersigned attests that his State of Californi ontractor's License # 71J-07
is in full force and effect and properly authorizes cation.
San Jose City Business License # 44 3
I certify that in the performance of the worklor which iK F rmit is issued 1 shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
� OWNER � ' - ° p 4
IZZB Lot No. Z
ADDRESS
USE OF BUILDING-
Signed
UILDING Signed....G-.... f-uP opx!�uGCR,�Ds.9�LS.......
280-20 (6-73)
1228 RTTPPF,T.T PLACE CENTRAL
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