968061101'KENTWOOD AVENUE
Tract No. Lot No.
CITY OF SAN JOSE BUILDINGDEP Rq TI�BNT
�Q "APPLICATION FO BUILDING PERMIT
Date Com. 2 19, 11_ Permit N
Application is hereb ad or a permit to
a —/ sfory, T, _ _ __ .rrA Byijd{ng��� se24e
at
to be occupied only as
in accordance with Plans,
Estimated Value of Improvements, Sek"0040' �9
I certify that* in the performance of the work for which this permit
in any mao r so as to violate the wo men's compensation laws of
Own r �� E Address
gy Address 161 ;
Foundetiew — Frame &
Sfucco Finish
.�fW 9a9
1101 KEQTWOOD AVENITE
DALE PEARSON
Occupancy
Parking Space
�'9 Sprinkler.
Emer. Elect.
I shall not employ any person
2.
Exemption from requirement for State of California for Contractor's License is hereby claimed by applicant:
as owner ❑ statement filed ❑ 2 z
Applicant attests that his State of California Contractor's License # ✓''1��J
is in full force and effect and properly authorizes this application.
San Jose City Business License
a 280-601 N
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S. APPROVED =() 9. REI
DISAPPROVE '
2. DATE RCD. XTIME RCD.
'A R EA 7. INSPT. MADE, `O
TIME 2
DATE
WHITE -FILE YELLOW - INSPECTOR PINK -OFFICE
671,