19442 7447 WILD FLOWER 'WAY
Building Permit Confirmed ❑
17 Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION/ FOR 77��MyECHANICALQPERMIT
Dafe... /D._�2.T........ 19 79.. Permit No.--------�C... ---------_....
The undersigned hereby makes application to the Plumbing Inspector of the City of San Jose
for a permit fo install the machenical work,listed,o,the reverse side.
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Exemption from requirement°for State�of'Celiforma=for Contractor s,Lv:ense is hereby claimed
by undersigned: as owner ❑ sfatemeni filed ❑p ! u
Undersigned attests that his State of California Contractor's License #
is in full force and effect and properly authorriiae$ this applicaation?may
San Jose City Business License # / ��,`•/ !N/% (-70rta1 �t
I certify that in the performance of the work for which this permit is issued I shell not agloy�
any person in any manner so as to violate the workmen's compensation laws of California. (�IIJJ Z
OWNER-
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ADDRESS / 7Y Wi/ �Io�l�l�Z� �" �1 Lot No.
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USE OF BUILDINGX
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lc. (?Q/YL "� Signed _.. .._ .0//. ---80- -
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7447 WILD FLOWER WAY CUSTOM HO C ORT CENT]
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