8819 (2) ' ,630 Peachblossom Dr.
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL
QPERMIT
Date-----MaY..�5..... ...... --------- Ig .-74 Permit No.----......V..JJ.-1.../..-------------------
The undersigned hereby�maka�applicatio_n=o the,,Plumbig Insp r of }he Cify of Sen Josa
for e permit to install 1ha�m'ilanicel wor4Jliated•on fhereverse side.
Esemp}ion from requirement'rfor State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement filed 25QD5D
Undersigned attests that his State of rC,aifornia Contractor'so ..... Gl
is in full force and effect and properly'aufhcri:esothis?ai7Olice}ion. �� J!
San Jose City Business License 9 44-01176
1 certify the
tin 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 John Bringuel
ADDRESS 7630 Peachblossom Drive Lot No.
USE OF BUILDING Singlefa . 1y ,residence
Signe - .. .... —---.--------------------
280-20 este Air ond.
Western A/C
x7560 Peachblossom Dr. .
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