93869 (2) 1111 KENTWOOD
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date—el
19_,Z" Permit No.Y N
Application is hereby made for a pe m' to
a—/—story, Type .c i Use Zone —!
at Occupancy �
to be occupied only as � /�n L V' mg Space
in accordance with Plans, Specifications and Plot-plan filedYierewith. Fire Sprinkler.
Emar. Elect.
Estimated Value of Improvements, $1.2 OD 6
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 fc v4afe��the�workmen's compensation laws of California.
Owner �2 f/_�[L_0 Address
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