16268 (2) 1625 JAMESTOWN DRIVE
Building Permit Confirmed ,❑
Not Required 1'd'
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
k
Date-......./_ .c-�✓f..�'...�. ... ......_-. 19..-..... Permit No.------
Tha undarsigneQereby makes application to the PI u 6'*-g Inspector of the City of San Jose
for a permit to install the mechb ;cal�wor listed on h rJvorse side,
/rte r � For .� f
Exemption from requlr men} 4or Sfetg oi�Calii rn ie,for Contra cfor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that his Stale of California Contractor's License # � �7
is in full force and effect and props lly-a tth/o izes this app nnc�ation.
San Jose City Business Licensr/X p(' /��JT1r✓.
I certify that in the performance of the ork for which this permit is issued I shall not employ
any person in any manner soalas to violate the workmen's compensation laws of California.
OWNER F =�N/f�LD
ADDRESS �lvo?5 S�/>7GSTDu/N Lot No.
USE OF BUILDING
Signe -
O8�0t
1625 JAMFSTOWN DRIVE FO r
Type of B.T.U. Remarks (Check V)
Appliance No. Input New Replace Relocate
Gas Ranges
Wall Heaters
Boilers (steam)
Boilers (Water)
Blower Furnaces 00112
Suspended Units
Clothes Dryers
FEES
Appliance Fee FEE
Q 0
Flues/Vents Fee
Flue/Vent Hood/Duds Fee
Hood/Duct Gas Piping Fee
Condensate Drain Cond. Drain
Permit Fee ;:7,Q Q
TOTAL FEE L(-- O
INSPECTION RECORD
Ducts Underfloor
Ducts Complete
Flues in Wall
Flues Complete
Appliances/Misc./j,. ,t?. >;raFr�'"� rlil�j/,-N� P
No. Gas Lines Outlets Size
Tested and Approved