7395 (2) 54'79 Bollinger Poad
Building Perms} Confirmed ❑
'
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date.?rd
.....v`-�. 7 .... 19 ,1.. Permit No...... -S ----------
ersigned hereby ma s p c ) n§��spaclor of the City of San Jose
for a permit to install the meth is {i( verPe�side,
Exemption from requirement for St a of California for Confrector's License is hereby claimed
by undersigned: as ow ❑�.. tat men} {'I
Undersigned a}tests that his Stafe�bfjfd ?r.nia r' ce so I, —`—(--
is in full force and effect and proper a i,r ihi i q.
San Jose City Business License #
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 as to violatt the wgrk en's compensation laws of California.
OWNER—
DDRESS / _//C — Lot No.
A
USE OF BUILDING���y ' 4�
Signed.- _ .. . a__ L . . .....
280-20 )6-73) 1
7479 Bollinger Road Tony Rossi
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