17130 (2) 1463 SARATOGA -SUNNYVALE ROAD
Building Permit Confirmed
Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date.._ .{... 3......._..._....._ .70 r... 19errni4 No.---...LZ/.3o---------------------
The undersigned hereby makey.epplication to the Plumbing Inspector of the City of San Jose
for a permit to ins}all +he mec 6hq ic�lork Ott
Exemption from req uirema �.e/f re Pf ¢a/n/�cf ac?License is hereby claimed
by undersigned: es own r ❑ statement filed ❑ p / / p
Undersigned a}}es}s that his State of California Co tractor's License # �(J 1[OC�U
is in full force and effect and properly authorizes this tcefion.
San Jose City Business License #
I certify that in the performance of the work for which this parmit is issued-1 s� not employ
any person in any manner so as to viola#e the workmen's compensMi.n laws of California.
OWNER __IZUWo )/11wnv-lli ��tr�t�1 C G� c✓
ADDRESS �0 3 S0.f G`{c�G G SU kcf le e Lot No.
USE OF BUILDING
Signed ......
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1463 SARATOGA-SUNNYVALE ROAD G2NERALn SHEETMET
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