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CITY OF SAN JOSE BUILDING DEP RTMENi
APPLICATION FOR BUILDING PERMIT
Date 19C Permit No. S7 ZO$
Application is hereby made for a permit to
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Occupancy j—
i - vt,lr Parking Space
to be occupied only as F•,r�e >/hnkfer
in accordance with Plans, Specifications and Plof-pled !81.XIJ
Estimated Value of Improvements, $. fS C5 .so
I cerfify 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 work an s compensation laws of California.
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