14688 (2) 1160 STEL"LING RD
Building Permit Confirmed-r3"
Not Required
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLI//CATION FOR MECHANICAL
PERMIT
Date_Z_-3--/.----------------------------- 19/.-7/_ Permit No. -
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.
Exemption from requirement for State of California for Contractor's License is hereby claimed
by undersigned: as owner 0 statement filed [� � ;3 n
Undersigned attests that his State of California Contractor's License #
is in fullforceand effect and properly a ho`xes this application.
San Jose City Business License #' t4 7
I certify That in the performance of The work for whichthis permit is issued I shall not employ
any person in any, Tanner so as to violate the Work en's compensation laws of California.
OWNER /�Lc/LW�
ADDRESS Lot No.
USE OF BUILDING—C&401rs
Signed -J/QAI. ------
2BO-20 -
1160 STELLING RD GRA DON SM/
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