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16850 (2) 7470 Tiptoe Lane Building Permit Confirmed O Not Required CITY OF SAN JOSE BUILDING DEPARTMENT APP�ATION FOR —7MECHANICAL /PERMIT � Da+e...........I /y 19./.x. Permi+ No...._....../..11� `J.-�L......... ... The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose fore permit }o install the mecha�e5j�k Ied�o/}'oi avpn�st�/sJ Exemption from requirement for Rat o Calif nia for Confracfors'License is hereby claimed by undersigned: as owner statement filed ❑ Undersigned attests that his State o Ce ornia Contractor's License # is in full force and effect and properly authorizes this ejiblicafion. � San Jose City Business License # 1 I certify that in the performance of the work for which this permit is issued I shall no}�PIoY any person in any manner so as to violatetheworkmen's compensation laws of California. OWNERj�l�/lam f7'7LL ADDRESS / /9n/.�/_xto+ No. USE OF BUILDING ���Sl ✓GF Signed..- .. .......----` ---- "- -..... ......... 7470 Tiptoe Lane Owner 280-404n T TT v+ m m m Z D O O n 2 O O v c c c c o c a 0 G o 0 0 N N n A O r• d H 4 7 ` T v 70 u n G1 2 S D T O 6 O G a -IT Q D n O v O 0 E N o d m m m v N N m n (� 0 S r N lD O 1 0 I m