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10207 (2) 3,9"2_ST�T,LTI�TG MoAb Building Permit•Confirmed ❑ Not Required []�� CITY OF SAN JOSE BUILDING DEPARTMENT APPLICATION FOR MECHANICAL PERMIT �6. .. 19.7 ..... Permit No. _ .J Date.._----....�.�.. .. . ....... ............. . ... ................ --------- The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose for a permit to install tha'7ch)�icat)jbr .liste���re�jide. Exemption from regyGepeptt iaat- oF'Cal ifo is r Can}rector's License is hereby claimed by undersigned: /as owner ❑ statement filed ❑�_ Undersigned attests that his State of California Contractor's J!Zans'e/# ��� is in full force and 'effect acid properly"authorizes .As/ppplic ofrw San Jose City Business License # 9-' � 4 I certify that in tha performance oe work for which } is permit is issued I shall not employ any person in any manner so as to violate the workmen's compensation laws of California. OWNERGa ADDRESS �� S / Lot No. USE OF 'BUILDING Signed-----...?f[«-.//!<—!< li�L2. v/G ----------- 280-20 (9-73) OAD h k �" O TOGA y 1392;. STELLING,=,Rfiw. - m Z D T T O O n n oa m oa m - 1 Q1 a n � n $ n m r S v K y w o ' ^ OCL p n � m � v - v 'o m ry 1 z Z w ^V z v t3: m T ry m � I16m m m