19079 826 SEPTEMBER DR D,e Tia l
Building Permif Confirmed ❑
Not Required ,-9—
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FO MECHANICALPERMIT
Date..SQP ....t.gq......................_... 19.:V$. Permit No.....,.. 6.Z ...------------
The undersigned hereby/makes application to the Plumbing Inspector of the City of San Jose
for a permit to install the/,;Vnjrww 1g6, dr�-t p � rtla.
Exemption from requfsemefi�f f�r ate o `Gjfgmia fe Contractor's License is hereby claimed
by undersigned: owner Er statement filed ❑
Undersigned attests that his State of California Contractor's License #
is in full force and effect and properly authorixesd is,pEptication /
San Jose City Business License # lam.//
I certify that in the performance of the wo�rV forwhich 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 J a!sse--R ScL-I-P-�-J—`-_A-. K 1 C 1 � Su V-QM
ADDRESS b pkv Lot No.
USE OF BUILDING Si Q
' Signed
280-4o4n
826 SEPTEMBER DR OWNER
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