10209 (2) 7551 MOLTZEN DR
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Da+e-------------------------------._............ ... 19------- Permit No.-------------LO>o`/-.------- -----.--
The undersigned hereb makes application }o the Plumbing Inspector of the City of San Jose
fora permit to instal lt�d' + f`Jarse side.
Exemption from a ate o orm Contrac}or's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑ /' /p
Undersigned attests that his State f California C tr ct r .2 7Y
is in full force and effect and properl ixes t
Son Jose City Business License #' S
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� iollattee the workmen's compensa}ion laws of California.
OWNER
ADDRESS t Lot No.AAY
USE OF 'BUILDING
280-20 (9-13)
7551 MOLTZEN DR PARKER S/M
c
rt Z D T T � O n 2 S n i m � G�
O � c c c c o o r o 0 0
� �p � O � n O y i ! �n �p ry
� � � 3 � 3 � � � �' C d m m `° � o i
� _ � _
� n � m O
O y
N � Z Z
4. ` � N C
\� \ ��� � 1 T CA
Q 1�,.1 � � ~ 0 -gyp -1
v
� � � � � �
A m � � 2 „
m
f1 � a ' a Z
Q O� � \ � a �
T O v O m n E N
H A D `° °. a » 0 3
w• � v `� � = � T a
N T m T T m �1 �
m „ � A m m �
� � m �
N a n
A T
A ry
`� � , � o <