10671 (2) 7515 MOLTZEN DRIVE
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date.-------/.-(...---'-----._..-----. 197: .. Permit No.----/`07-1----------------_..
The undersigned her'FS ke p 'ca ' n fy�f{� l9 Inspector of the City o4 San Jose
for a permit to ins}a11 jH �c st�o`grm}(tR sa side.
Exemption from ra u�rama for } e o eli orn a Contra cfor's License is hereby claimed
by undersigned: as owner ❑ statement.filed 2 (:G SCJ 5C. 'y 3
Undersigned attests thathis State of �� w Cont fops'
9
is in full force and effect and properly e t : y40
//
San Jose 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 workmen's compensation laws of California.
OWNER er2o d q /
ADDRESS 7�/5 / OIfZe1s Lot No.
USE OF 'BUILDING r'5
Signed..... . . CQ
280-20 (9-73)
7515 MOLTZEN DRIVE PARKER SHEET METAL
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