13860 (2) 8145 PARK VILLACIRCLE
v Building Permit Confirmed ❑
1... Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date
Date_Aij/ CL'......d................ ..... 19 .7... Permi# No......1,�.. (QF� ................
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
for a permit to install the mechanical work listed on the reverse side.
Exemption from requirement for State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed
Undersigned attests that his State of California Contractor's License #
is in full force and effect and properly authorizes this application.
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 /ZOfg r l_vo7QN(acc
ADDRESS / fll IC U10-A OF . Lot No.
USE OF BUILDING / n /
Signed........&- �C�.y.....� acwudl c&..........
280-404n
8145 PARK VILLA CIRCLE - OWNER
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