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53821 (2) 1043 Colony Hill Tract No. �53 Lot No. gcl CITY OF SAN JOSE BUILDING DEPARTMENT APPLICATION FOR BUILDING PERMIT``'']j Dates )l)A)k /6 . 19 97 Permit No.� Application is her y m d o , p '4 to �Q a storY, Type �6 e< 2$a Use on :peYP ai L 141—<, Occupancy, to be occupied only as-LAf JQ Jc Parking Space 2 in accordance with Plans, Specifications a lot-plan h rl¢v� F Sprinkler — Estimated Value of Improvements, $ Q �v Exemption,f./rom requirement for State of California for Contractor's License is h reby cle imed by undersigned: as owner statement filed ❑ Undersigned attests that his State of California Contractor's License # is in full force and effect and properly authorizes this application. San Jose City Business License # I certify that in the performance of the work for which this permit is issued I shall not employ any person m any manner soas to viola# he kme s compensation laws of California. G� �n Owner �tl ivr��/jAddress�� ° "r' vC By r Address /// 1043 Colony Hills Barbara Dodsworth ( � P r 99/5—W01—I o8z w,oj 8961 r z Joe ysiuld 000n{S Oyu uoifopunod ' 'v ` N01103dSN1 dO (180338