22372 1647 Tu8darly P1 . PHONE: 277-4591
I Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
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Date..................( L.V.... .._. 19-.q. Permit No.---- - - h .1. ..
1 \
The undersigned hereby makes application to the Plumbing Inspector of the City of Sen Jose
for a permit to install the mechanical work listed on the reverse side.
Exemption from requirement for State of California for Contractor's License is hereby claimed
by undersigned: as owner ❑ statement file ❑����^
Undersigned attests that his State of California Contractor's License cl
is in full force and effect and properly authorizes this application.
San'Jose City Business License # _�2 ���
I certify that in the performance of the work for which this permit is issued I shall not employ
any person in any manner sos to violate the workmen's compensation laws of California.
OWNER_�
ADDRESS IOy? rVSC9/t/`/ _024 Lot No.
USE OF BUILDING ,9M < —�
. QhaN< Signed.......... . ... ........ . ------------...-----.... ..... -
i,la6- X0/0 6 1 't k/
1047 Tuscany Pl
-Holt & tnTie 1
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