16850 7470 Tiptoe Lane
Building Permit Confirmed O
Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APP�ATION FOR
—7MECHANICAL
/PERMIT
�
Da+e...........I /y 19./.x. Permi+ No...._....../..11� `J.-�L.........
...
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
fore permit }o install the mecha�e5j�k Ied�o/}'oi avpn�st�/sJ
Exemption from requirement for Rat o Calif nia for Confracfors'License is hereby claimed
by undersigned: as owner statement filed ❑
Undersigned attests that his State o Ce ornia Contractor's License #
is in full force and effect and properly authorizes this ejiblicafion. �
San Jose City Business License # 1
I certify that in the performance of the work for which this permit is issued I shall no}�PIoY
any person in any manner so as to violatetheworkmen's compensation laws of California.
OWNERj�l�/lam f7'7LL
ADDRESS / /9n/.�/_xto+ No.
USE OF BUILDING ���Sl ✓GF
Signed..- .. .......----` ---- "- -..... .........
7470 Tiptoe Lane Owner 280-404n
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