14163 1110 SCOTLAND —DF�--
Building Permit Confirmed ❑
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
31...... 1977.. Permit No........./t�I
Dale ............. ..._...... .3..- 7 -,41-3 ..... .......
The undersigned hereby m9ke applicafion to f a Plumbing Inspector of the City of San Jose
for a permit to install the m Eha I orW fit �era �r}��
Exemption from req uiram�eo}� �t off elifoinidF Zeit for's License is hereby claimed
by undersigned: es caner ❑ statement filed ❑
Undersi ned attests that his State of California CdMracfois Lice e # -
is in Full Force and effect and properly authorizes thisy ';l11ige./
San Jose City Business License # 116
I certify that in the performance of the work for which thispermit is issued I '$hall not employ
any person in any manner so as to violate the workmen's compensation laws of California.
OWNER Valley Title
ADDRESS 1110 Scotland Drive Lot No.
USE OF BUILDING Rpsidenc
Signed-----
1110
---1110 SCOTLAND DR VALLEY 1-1480-404n
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