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22405 5825 BOLLINGER RD PHONE: 2]]-4581 — / - Building Permif'Confirmed (yam Not Required ❑ CITY OF SAN JOSE f BUILDING DEPARTMENT APPLICATION FOR MECHANICAL PERMIT Date.-.... :. -19.rf... Permit No.............. . .Y-�. .�...... 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. Esemption—rf oomm requirement for State of California for Contractor's License is hereby claimed by undersigned: � as owner ❑ . statement filed El` Undersigned attests that his State.of California Contractor's License # . is in full force and effect and properly authorizes this a'jpIic�aytion. San Jose City.Business License . I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to violate the wor OWNER an's compensation laws of California. LUTHG /I�✓ (iff�t 'ADDRESS .JS42S �OG�/YGc2' �•^ Lot No. USE OF BUILDING Signed .. .................. .. -------- --- 280-404N .I iy 5825 BOLLINGER RD o © o � g u m m S U N U m w N LL o 0 o w Q 4L '1 tD U 6 ai J � jje U LL 2 U A O LL tL Q Z F