12870 (2) 1655 SARATOGA/SUNNYVALE RD
Building Permit Confirmed
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLIICATION FOR yM/ECHANICA/L PERMIT
Date./V.'-7....................----..... 19/L� Permit No...-G- -�F.z -----
The undersigned hereby s appl' ti the Plumbin Spector of the City of San Jose
for a permit }o install the m ch I o n}�ei i ee.
Exemption from require t fa Ca if ni or a rector's License is hereby claimed
by undersigned: as weer ❑ statement filed ❑
Undersigned attests that his State of Celiforn' Contractor's License # �¢' 33 Z-Z/
is in full force and effect and properly au}honxj5 7ppl�iy�l-to . �'/�'/�
San Jose City'Business License # �/ / / / /L4 Y
I certify that in the performance of the work for which this permit is issupe I shall not employ
any person in any manner s?'11-jp violate the work m 's compensa 'on laws of California.
OWNER
ADDRESS J~ t No.
USE OF BUILDING /
.. ��a '
Signed.... . . / - ... -r- - - ...
280-20 '
1655 SARATOGA/SUNNYVALE RD EHLERT S/M
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