16430 1236 YORKSHIRE DR
Building Permit Confirmed ❑
Not Required -e—
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL ,P/ERMIT
Date........8- /Vp----....._....... ._..... 1977. Permit No......_/.OP! ---......
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
forapermit to install The mechanical work listed on the.reve,s side.rja
Exemption from requiremanf�fo`STete o%C ifo a fo��Cr— orsaLicense is hereby claimed
by undersigned: as/owner �, statement filed ❑
Undersigned attests That his State of California Contractor's License #
is in full force and effect and properly authorises Ihis�application. �� ��
San Jose City Business License # ` r t
I certify that in the performance of the work'for which this permit is issued I shall not employ
any person in any manner so- to viol) the workmen's compensation laws of California.
OWNER ey>ve F41041+gQ^,"
ADDRESS 1236 yr l:Jl�iar �Ys�(+� Lot No.
Y
USE OF BUILDING /2eS:desv f R
Signed ...... -- ^... .. .
280-404n
1236 YORKSHIRE DR OWNER
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