12226 1040 TUSCANY PL. '
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL- PERMIT
9-27-76 ( ZZ2�
Date----------------------------- ----- - --------- - 19........ Permit No._....._--- ...---
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
fore permit to install the mechanical o,rsk�listed on.rh roversa%side.
Exemption from requiremont— - +atetofyC�alifornia for Confraclor's License is hereby claimed
by undersigned: as owner ❑ statement filed ❑
Undersigned attests that his State ofCalifornia Contractor's License # 1 1 oa2.9
is in full force and effect and properly authorizes this pplicatiionn
San Jose City Business License # /�/C-747 `
1 certify that in the performance of the work for which this permit is issued 1 shall not employ
any person in any'mannar so as to violate the workmen's compensation laws of California.
OWNER Pond. Homes
1040 Tuscany P1. Lot No, 2
ADDRESS
USE OF 'BUILDING Res.
S.xw CARLOS SHEET METAL WORK§igZ _ --._-_
280-20(9-y 9 OLD COUNTY ROAD
1040 CIA !`O � LoRNIA SAN CARLOS SHEET METAL
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