13006946 November brive
Tract No.
CITY OF SAN JOSE
APPLICATION
Date — a ,19
App ication is hereby ma,defor.a p�rrgj
a �_ story, Ty%p rj
at /1� o-IY�M�g�
to be occupied only as _ C
in accordance with Plans, Specifications
Estimated Value of Improvements, $ _
Lot No.
BUILDING DEPARTMENT
FOR BUILDING PERMIT I - ,
Permit No. I X -,a. —J< --
Use
.LOSE •F�OKY ,�6(t/(
_ Use Zone_
� Occupancy
����� So feet _ �s
file herewi Parkig•Space
Fire Sprinkler
Emer. Elect.
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 C�;JPP/H&X "ry-/D NI6 Address 7 �6 AVB (/C'/`•ffjG %� �/L•
By ��$'A�1J1%-Y/ Address
This permit shall expire and become null and void if the work authorized by it is not commenced within
120 days from the date issued or if the work is suspended or abandoned for a period of 120 days after
commencement. C7_2�B -7a I
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