51581107 Kentwood avenue
Building Permit Confirmed 1211
Not Required ❑
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR MECHANICAL PERMIT
Date
-.Y.-/�....._-.-......... 197. Permi+ No.......... --------------
The
--------Tha undersigned h�roby es�,gppl f a PI b' g side. Inspector of the City of San Jose
for a permit to instal f o n 1 ,tis#e o r a Se side.
Exemption from require nt fo #e art aIlfor.,a r Contractor's Licen is hereby claimed
by undersigned: as owner � statement filed!
Undersigned attests that his SiatCCpCQ,,,,,��of California Contractor's License
is in full force and effect and props/I])puThori:e �j� jp 'cafio .
San Jose City Business License '4Y10 �(/
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 to violate the workmen's compensation laws of California.
OWNER :yaA/1) C. 1n DRG -AA)
ADDRESS ll o 7 k1E )7 JoQb AUE , Lot No.
USE OF BUILDING 4iN6L� F�srli�� DGJFGL/ti��
Signed ... ---
280-20 ' a
1107 Kentwood morgan
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