15837 (2) 7369 ERIN WAY
Building Permit Confirmed ❑
q No} Required ❑
CITY OF SAN JOSE G / BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
2RMIT
Date..... ...(......:..2 - -_......... 19_ Permit No..._!.....`........ ..� .. .......
The undersigned hereby makes application to the Plumbing Inspector of the City San Jose
for a permit to install the mechanical work listed on the reverse side.
Exemption from requirement for State of California for Contractor's Lice se s hereby claimed
by undersigned: as owner E] statement file DrT
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Undersigned attests that his State of California Contractor's License 7
is in full force and affect and properly autho ':e isapR ice
San Jose City Business License #
1 certify that in the performance of the work for which this permit is issued I shall not employ
any person in any manners to violate t e workman's compensation laws of California.
OWNER : p
ADDRESS &3 / Lot No.
USE OF BUILDING_
Signed.. . .... .' - - - -- - Al----- l�
639 ERIN WAY
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