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Tract No. S7 8 Q Lot No.�
CITY OF SAN JOSE BUILDING DEPgRi .'
APPLICATION FOR BUILDING PERMIT 77
Date
-, 19 Permit No.
Application is hereby made for a permit to
a
—4z-,story, L�E _ _ suse Zone X46-11401
at LN1.°l6� Occupancy��k�/
to I7eSoc�y�ed only as /C/`I7 J Parking Space Q
in accordance with Plans, Specification an Plof-plan file herewi Fire Sprinkler
P .U9Vi.
Estimated Value of Improvements,
I certify that in the performance of the work or which this permit is issued I shall of employ any person
in any mann r so a to violate the workmen's compensation laws of California.
Owner AddressC/0 SrMA'72/(_4-Q-6-f�
By / Address
RECORD OF INSPECTION`
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Foundatio ,-/�-/—/!
Stucco ,,� Finish4-/4`77 51�'Z
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T573 I ROILING R 0 DEMETE UILD SR
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Exemption from requirement for State of California for Contractor's License is hereby claimed by applicant:
as owner ❑ statement filed ❑ p
Applicant attests that his State of California Contractor's License #- Q�CG54
is in full force.and affect and properly }puthorises this application.
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San Jose City Business License # a y
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280-601 N