NO PERMIT NUMBER Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date 19____ Permit No.
Application is hereby made for a permit to
—
a--story, Type---- Building_ Use Zone
at .__ Occupancy
to be occupied only as Parking Space
Fire Sprinkler
in accordance with Plans, Specifications and Plot-plan filed herewith. Emer. Elect.
Estimated Value of Improvements, ;
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 Address
By Address
RECORD OF INSPECTION
Foundation Frame
Stucco Finish
260-601N '�
— FLOWER
dta, 1AIBJ�1�l�S
Exemption-rrom-reyuneri.e,..-.or State of California for Contractor's License is hereby claimed:-by applicant:
as owner ❑ stafemen+ filed ❑ f
Applicant attests that his State of California Contractor's License #
is in fell force and effect and properly authorizes this application.
San Jose City Business License #
288-601 N