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12283756-1 BOLLINGER ROAD CITY OF SAN JOSE S Building Permit Confirmed 1�1— 9Not Required ❑ BUILDING DEPARTMENT APPLICATION FOR --7MECHANICAL PERMIT Date.( tob ... �P............ 19./76.Permit No. ----------....... The undersigned herebye alp e'o o9f nspecter of the City of San Jose fora permit to install the m cha i I d }fj§ e r side. Exemption from require o ate o Ca iforn/a for Contractor's License !;,hereby claimed by'undersigned: as o nor ❑ statement filed Ili Undersigned attests that his State of California Contractor's Lice # C/ is in full force and effect and proper) uth ri s }hiy ,ais io San Jose City Business License # L.� I certify that in the performance o e k for whi h this prermnit Tossr0�shall not employ any person in any manner so as to violate the workmen's compensation laws of Celifornie. OWNER ADDRESS USE OF Signed ----5 ft1FIF 561' BOLLINGER ROAD E� FTA m STING CFk - � n � \D x ® - © o © � n � \D