20299 (2) 7945 FALL CT /�
�.Q//'I� 'VA''rf B lding Permit Confirmed [I
Not
Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date.. �✓1-- ...... I t9�./.. Permit ....
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
for a permit to msf II IN�(n ha P o"rk-lfste ons reverse side.
Exemption from-regGire enl�o Xa -of Cifo� for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that Iu ;tS{e of ig a�Via6or'( Lbnse # �Z f�
is in full force and effect and properly u 2ri7s�hr pli�t+d
San Jose City Business License #' `f' Y 4
1 certify that in the performance of the work for which }hispermit is issued I shall not employ
any person in any manner so as to violate the workmen's comp amation laws of California.
OWNER
ADDRESS—T 9�� I--, Lot No.
USE OF BUILDING j
Signedc<aLo'
7945 FALL CT ATLAS HTG & VENT 04n
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