53292 A38 Liberty Ct.
Tract No. �k3 02 Lot No. 21
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT -j
Date &4-4 s , 196 7 Permit No.
Application is hereby made for a permit to Build
a story, Type P002:). uildi Use Zone #'L!
at 03A TA harty C Occupancy
to be occupied only as Pry Pool Parking Space
in accordance with Plans, Specifications andPlot- d heyait �/�f?'nkI
Estimated Value of Improvements, $ /��, ' v C.•�`-
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 #174905
is in full force and effect and properly authorizes this application.
San Jose City Business License # 4— 5226 '
I certil at in the performance of the work for which this permit is issued I shall not employ any person
in any m nne so s to viol the workman's compensation laws of California.
Ow /� T Address C t.
By Address !-111 )A tr�Li
938 Liberty Ct.
Dale Smith r P
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