517571129 Stafford /Vo
Tract No. ?/R-9 Lot No. /c
CITY OF SAN JOSE BUILDING DEPARTMENT
''II APPLICATION FF R`BUILDING PERMIT
Date IN 19 Permit No. 5—%'S_
Application is her by made for �a permit to oNdr4 T
a � s+ory, Type_�(R.✓ 'Buildi� Use Zone
f�f�_�Po. ,.���f✓�� ,fI�V'�JC Occupancy I
to be occupied only asTl��TS. ParkingrSpacey
in accordance with Plans, Specific tions and Plot -plan -filed filed he' rev i#Fire�Sprier
Estimated Value of Improvements, $, 000. ou
Exemption from requirement for State of California for Contractor's License is hereby claimed by undersigned:
as owner ❑ - statement filed ❑ —
Undersigned attests that his State of California Contractor's License # /J�/ /ff
is in full force and effect and properly authorises this oplication.
San Jose City Business License �}'_9-�O��
I certify that in the performance of the work for which this permit is issued I shall not employ any person
in any maggerAo a, to violate jhe workmen'&ccompensation laws of. California. �� �. '— 'k
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