106727504 KINGSBURY PLACE
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
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Date -------------------------------
19 6-- Permi+ No... -- - ._....1...........................
The undersigned hereby ma p'Jyis�� I e the City of Sen Jose
fora permit fo ins#all the me an'ESL�Y' e ¢
Exemption from requiremo for S} a of Ca ifornia for Contractor's License is reby claimed
by undersigned: as owner ❑ statement filed —%U ppis--N3
Undersigned attests t a his State of Calif a�.o a Pli ors is n,/12�L—
is in full force and affect and properly �a1u}/h �rix applic
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 workmen's compensation laws of California.
OWNER
ADDRESS
Lot No.
USE OF'BUILDING
Signed.... _/�CiL..�' {1... ........-- ....
28o-7gRq') IN(1SB1RY PLACE PARKER SHEET METAT,
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