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Tract No. a0 2 d Lot No. 3 J
CITY OF SAN JOSE BUILDING DEPARTMENT
PLICATION FOR BUILDING PERMIT
Date - 19Permit No.
Appli atio is hereby mador a permit to �ciiG /7
a < story,Type (/ Building Use Zone
at _ Occupancy
to be occupied only as Sq.feet
in accordance with Plans,Specifications and P fi r i In Space
Estimated Value of Improvements, $ I prinkler
Enter. Elect.
1 certify that in the performance of the work for which this permit is issued 1 shall not employ any person
in any mannaerr so as toviola a the workmen's compensation laws of California.
Owner`d• Address ✓
By 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.
FINAL INSPECTION - 280401 N
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