591561067 November Dr. ll
Tract No363,,T Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date 1 clivo 14 ' , 196A, Permit No. �S
Application is hereby made for a permit to n "� - � L - orb
y, pe d Bu' Use Zone Sr
b•= stor T�
at p 6 sf y i� • 1� ���—Occupancy
to be occupied only as—o_ e— � ,Q ,Parking Space
in accordance. with Plans, Specifications ap 1o�Y�lan prinkler
Estimated Value of Improvements, $_ A- f Z—g
I certify that in the performance of the work for which this permit is issued I shall not employ any person
in any manpr s2J as to viqlete a workmen's compensation laws of California.
Address �O �v —%--v�'a"—r
By—j-7 Ifih' Address /62o/C!✓n.yCa
RECORD OF INSPECTION
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