15370 (2) 7592 HOLLANDERRY Y� �w��f�i47wr�f Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
370
Date...14v�__0(... 19 .7 Permit No..._... . ... ------.....
The undersigned�er b ^rJ�yke�f ap lie t'o to th Plumbing-Isstpec}or of the City of San Jose
for a permit to instdll r(dh3 lfs} o } r Jers4 sr e,
Esemption from-fbQu �e far'St of-Cania f.r4rC- fractor's License is hereby claimed
by undersigned: as owner statement filed ❑
Undersigned of}as}s that his State Ca rnia Contractor's License
is in full force and effect and properly aLJlEofixas this apyli9afi9n ___
San Josa City Business License #�
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 woworkm/en's compensation laws of California.
OWNER ��CL^ �E�
ADDRESS 7 SAU t�_P�1_L�N��• Lot No.
USE OF BUILDING F"
Signed .. .------------ - ..................-
7592 HOLLANDFRRY OWNER 280-4o4n
Type of B.T.U. Remarks (Check V)
Appliance No. Input New Replace Relocate
Gas Ranges
Wall Hea#ars
Boilers (Steam)
Boilers )Water)
Blower Furnaces
Suspended Units
Clothes Dryers
G �—
00
FEES
Appliance Fee
Flues/Vents Fee
Flue/Vent Hood/Duck Fee
Hood/Duca Gas Piping Fee s �Q
Condensate Drain Cenci. Drain
Permit Fee o'7 c:-,_�
TOTAL FEE
INSPECTION RECORD
Ducts Underfloor
Ducts Complete
Flues in Wall
Flues Complete
Appliances/Misc.
No. Gas Lines Outlets Size
Tested and Approved