12089 (2) 7',497 KINGSBURY .PLACE
Building Permit Confirmed ❑
Not Required
CITY OF SAN JOSE �� BUILDING DEPARTMENT
APPPLICATION/ FOR MECHANICAL PERMIT
Dafe ....... ------- 19 19...._.. Permi+ No.- ..................
The undersigned hereby makes li fio t }h Ium sp or of the City of San Jose
fora permit }o install }ha mocha is e ryd
Exemption from requirement or Sia o{ Cali ornia or Con}rac+or's License is hereby claimed
by undersigned: as own r ❑ statement filed '
Undersigned d attests that his State of California fionlr�e+or's Ljjj' s'
is'iin full force end effect and properly eu horixe=y+fi i�//pliceiios�//U
San Jose City Business License .}k_
I certify that in }he performance of the work for which this permit is issued 1 shall not employ
any person in any ,manner so as to violate the workmen's compensation laws of California.
OWNER (� �� "/"7I�OL 7— p
ADDRESS _f�_!_!_Y��' / 6 G r Lo+ No.
��
e ..
USE OF BUILDING
Signed --------- r - 7
2BO-20 (9-73)
7,197 KINGSBURY PLACE 0 EMOST HEATIi
� o o
T T T v m m
N r n \/ �• � C y v � O q � M N d � "O �
O O ( p o m d A d• fD
CL
O O
n O A O
• Z 1. O
I N
Mem
O n f Y iA
2
A n n G1 2 T D
m o d o c a
n + o N a Z
ITTT
w � T
a
N p S
N ry
I� m