10330 1382 STELLING RD
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION ATION FOR MECHANICAL
PERMIT
Date..
Date_..__.7/1. -----`------------- 19-'2 .- Permit No---10-S-30-------------------
,The undersigned haleby makes application to the Plumbing Inspector of the City of San Jose
for a permit to instal me�m eniCa or4'list y} jbver�side,
&emption from�s i�`min4�fo }e ofl r /fQ/r�Contrador's License is hereby claimed
by undersigned: ` as owner ❑- statement filed ❑ p
Undersigned attests that his State of C�ifornia Contractor's License #
is in full force and effect and propel autli rAigs•this appli
San Jose City Business License �j- 9.�faji �
I certify that in the performance of the work for which this permit is issuad I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER--& 1 do
ADDRESS Ax Lot No.
USE OF BUILDING
Signed ----- ----
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