3011 7656 Rainbow Dr.
Building Permit Confirmed ❑
Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date----------------------------- //O._....... 19 Permit No.- ........v w/ ------------
The undersigned hereb ma es applica ion o the Plumbipg Ins a of the City of San Jose
fora permit to install ih mach R.a 9 er
Exemption from req a a}e a a o C it,
or's License is hereby claimed ,
by undersigned: as wner ❑ statement file E] 258540Undersigned attests that his State of California Co rocfor's License
is in full force and affect and properly authorizes }hi a
Sen Jose City Business License
I certify it at 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 Donald Rosburg
ADDRESS
7656 Rainbow Drive Lot No.
USE OF BUILDING residen/c/e ----- ..... .... --.
leo-2o
7656 Rainbow Dr. _ Valles Heating
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