6424 (2) 7549 Fallen Leaf Lane 1
Building Permit Confirmed ❑
Not Required --Ej—
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date...............2��4.......------------ 19�. Permit No.-------......... -- ----
The undersigned hereb k s ;;}}} o thg�-P-lyrri ng. ctor of the City of San Jose
for a permit to install t .? od/ r v i
Exemption from req irement r State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that his Stat f 'fprnia i�
is in full forca and effect and proper art rites is a p c((tiddrr�r
San Jose City Business License # 41J C)57�
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 violate the workmen's compensation laws of California.
OWNER
ADDRESS_1S4O PLS r �—� Lot No.
USE OF BUILDINGL'L'k0
�S/DC;u'�AZ FfP—ffT!/j 6— Signed-------------..............-------- ----- ----
280-20
7540 Fallen Leaf Lane Residential
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