4988 (2) 7465 Fallenleaf In Building Permit Confirmed ❑
Not Required !�
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
- -----------
Date--- -- //.Y... I7-------.-. 19 v �f
' ./7./... Permit No.-....-..- --- ' '-------..---....
The undersigned hereby ekes apglliggtio t PI mbin Inspector of the City of San Jose
fora permit to inziell th m i I sY6rk on i r rse side.
Evempiion from req r S+a of ali(o > trac}or•z License is Hereby claimed
by undersigned. s owner ❑ L state {' d
Undersigned attests that his State of Celiforni o�?tor's m ns
is in full force and effect and properly auth r' }his appli'ccaa}ion.
San Jose City Business License # �G09/ ?/
I certify that in the performance of the work for which this permit is issued I shall not employ
any person in any manner soso as to violate the workman's compensation laws of California.
OWNER
ADDRESS ��Gs- G/� ��AF G/1✓rc Lot No.
USE OF BUILDING E-S',/ 'VC
Signed----- ........---- --- -or
280-20 (6-73)
'7465 Fallenleaf '�n�s g FssA encs, /mac
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