184 7684 West Hill Lane
Tract'No. 3r� O Lot No. '2-
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date_A/o ✓, 7, !9 19_76— Permit No. 001'e4
Application.is here made for a permit to 112• 4 F��1 Pit AooJ
a
—/—story, Type Buildin Use Zone
et _ Occupancy 7
_ Parking Space 'Y
to be occupied only as Fire Sprinkler
in accordance with Plans, Specifications
,#-p et n'filelf #J+
no Emer. Elect.
Estimated Value of Improvements, $
I certify that in the performance of the work for which this permit is issued I shall not employ any parson
in any manner so as to violate the workmen's compensation laws of California.
Own 13G Z E� Address
By /( Address
RECORD OF INSPECTION dtf. /-l0' 7
Foundation_ Frame d -a
Stucco �2 r Finish �' �-7"7� STI�U7-
260-661N
7684 West Hill. Lane
Exemption from requirement for State of California for Contractor's License is hereby claimed by applicant:
as owner statement filed ❑
Applicant attests that his State of California Contractor's License #
is in full force and affect and properly authorises this application.
San Jose City Business License #
I
280-601 N