16013 (2) 6677 JOHNS DR
C Building Permit Confirmed ❑
No} Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date_... 11 //..............__. 197? Permit No........./6.���................ ......
......... .... ..... ..
The undersigned hereby makes�applicafiongto,, the Plumbing Inspector of the City of San Jose
for a permit to install the nr h nmol
n} ty rk li fed n�� r�
Exemption from mquiremeor'Sate of�California for,Coet'actors License is hereby claimed
by undersigned: as owner ❑ statement filed
Undersigned attests that his State of California Confracto�s License'
is in full force and effect and properly authorizes'� hieap Ji� ri..
tioj
San Jose City Business License # J� _• 0 � /
1 certify that in the performance of th'e work for which this permit is issued I shall not employ
any person in any mann^: so as to, violas .the wodmen;S compensation laws of California.
OWNER VW'��UA I /
ADDRESS ee 6777- ti l o K Nt $ n R Lot No.
r
USE OF BUILDING
Signed----- .e-11-vi:-h.'------------= . .. ------ --
u Geo 5-dp
6677 JOHNS DR RUFFO MASOfZY 404n
Type of B.T.U. Remarks (Check d)
Appliance No. Input New Replace Relocate
Gas Ranges
Well Heaters
Boilers (Steam)
Boilers (Water)
Blorer Furnaces
Suspended Units
Clothes Dryers
� s �
FEES
Appliance Fee
MISC Flues/Vents Fee
Flue/Vent Hood/Ducts Fee
Hood/Duct Gas Piping Fee
Condensafe Drain Cond. Drain
Permit Fee Z
TOTAL FEE
INSPECTION RECORD
Ducts Underfloor
Ducts Complete
Flues in Wall �,01- �7 i
Flues Complete
Appliances/Misc. ��" 11--"7, • ��
No. Gas Lines Outlets Size
Tested and Approved