9562 (2)8134 PARK VILLAM
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE / BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
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Date---7.--._---....-----"�--..... 199-6_ Permit No.._..... ------------------------------
The undersigned haby makes'applice+ioo) to'+hepPlumbing Inspector of the City of San Jose
fora permit to instalvthe mechvanical"workbli,syte
Exemption from requireYin/tfor�Statpe>d .o, ri +hpe'.r.ev'rer,se=�caiid
e�
of Californ is cfor Contractor's License is Hereby claimed
by undersigned: (/ as owner ❑'statement filed
Undersigned attests that his State of California Contractor's License # 2
is in full force and effect and properly authorizes f��a�icattion/. �J/
San Jose City Business License # JX
1 certify +hat in the performance of the work fo hich 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 kAYV 4 L, -n
ADDRESS �Lz q I --Am UI 1I A Lot No.
USE OF'BUILDING ee
Sigtd-
280-M�
8134 PARK VILLA HEARTH FIRE
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