12306 (2) 1655 SARATOGA-SUNNYVALE RD
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date---__/45_77.../_41.. 19- 1. ..-a--.....�-
r .. Permit No............. .. 2 0 ...... .....
The undersigned hereby , e/s application to the Plumbing Inspector of the City of San Jose
fora permit to install the m fha((((((''/////'''m YJJJJ}}}}����k i fod�}hy ra eFjj99 i r.
Exemption from requi,X*_G_ Mf.4�Cwarni6 for�Cb r at�s License is hereby claimed
by undersigned: as 7 ner ❑ statement filed ❑
Undersigned
attests
that
his Sfa}e of Celiforni,gg Con}rector's License # . 32-0 3
is in full force and effect and properly u oriiz i top icon.
San Jose City Business License # [ L
I certify that in the performance of the work For which }his permit is issued I shall not employ
any person in any manner
so as to violate the workmen's compensation laws of California.
OWNER_6�l 2/V 5 &0&15
ADDRESS 6S.S i � Lot No.
aN VW�'yLRLF O
USE OF BUILDING
but
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