8696 (2) 20655 Cleo gve:
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date------lar_a/ 191.-x_. Permit No......Q..yP....L,C�.....`-.-.-...._--
--- -T-.._..............
The undersigned��l e�roby 1nar�e ap ice to e,Plu bing�l specter of the City of San Jose
for a permit fo inst511 t o a 'tied n �f��e^ a}da,
Exemption fro�.r i at for t e o li 04.I �}actor's License is hereby claimed
by undersigned: as owner. statement filed ❑ //� a
Undersigned attests that his Sate of C lifornia Contractor's License # �/2<9 )6> f>
is in full force and effect and plo�er uthorize is p ti,n�
San Jose City Business Lic��."!
I certify that in the performance of the work for which this per it is issued I shall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER - 2p&/ 2
ADDRESS a� S C�lOt47 14'• Lot No.
USE OF BUILDING
Signed'--....''--/--- --- ------ � j2'G -------------
280-20(9-73) A�
20655 Cleo Ave. Western A/c
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