13333 (2) 1059 TUSCANY PL
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date...........1-_...20-""........7.7......................... 19..._... Permit No...--- .3.
..� .3 .
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
for a permit to install the mechanical work listed on the reverse side.
Exemption from re utris t fa State of California for Conkrector's License is hereby claimed
by undersigned: s ner / //essta}ament filed ❑
Undersigned attests tliss Ste of Ce iforfra No" License #
110828
is in full force and effect e d properly authorizes this application.
San Jose City Business License # 47-00_61
1 certify that in the performanceof the work { r which thi09 ry1'�r's ad(Ljati not employ
any person in any manner so as to violate the workmen s compensation laws of California.
OWNER Pond. Homes
ADDRESS 1059 Tuscany P1. Lot No. 4
USE OF BUILDING Res
SAN CARLOS SHEET METAL
779 OLD COUNTY ROAD 280-404n
SAN CARLOS, CALIFLDkiiIA
1059 TUSCANY PL SAN CARLOS
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