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26614 (2) Fill KENTWOOD AVENUE Building Permit Confirmed ❑ �j Not Required ❑ CITY OF SAN JOSE / BUILDING DEPARTMENT APPLICATION FOR PLUMBING and/or GAS PIPING PERMIT Date....- ........... /... ../ .�...... ..... 1�7 Permit No......r�.6)0T The undersigned her by mak a pl' tion�p.t a P �g Inspector of the City of San Jose {ora permit fo install f' r n �j6rJpj�4�jiS1 on the reverse side. Exemption from I e a a of Grjfifo'rrnia oor Contractor's License is hereby claimed ley undersigned: as owner ❑ statement filed ❑ 7 Undersigned attests that his State rota o fr r' n e is in full force and effect and properI t' Sen 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 in any manner so as fo to the workmen's compensation laws of California. OWNER ADDRESS 1111P�17Gf/�D� /!r Lot No. USE OF BUILDING Signed ..... `1 �7 PpGGL/yi�///l�� 2�n P,z 1111 KENTWOOD AVENUE W �/ "" c W N F > C S T O v 1n �E f F 7C H WIE 'o 1 E, o 0 G O N Y � a ? N N N m r O N O " Z O T m m W > W > w > Wa Tfn G'1F �n ZE t K A O N `d, fD 1p A o 2 T a .T iT iG1T 1 � HO O rn n E TT > n A r m '° R T O C) T � 'T A o m I e Z H m H N m > 2 A ' m z A v m