76131 1535 Jamestown Drives qS ra"'
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date 3-2�_ 197? Permit No.
Application is hereby m1,1 jr p r t
a_ story_Type - - y Use Zone
at - ' 9� Occupancy /
to be occupied only L / .YB�/ Parking Space �-
P y as•L,F?aa"-- `/ - Fire Sprinkler
in accordance with Plans, Specifications and Plot-plan filed herewith. Emer. Elect.
Estimated Value of Improvements, $ / 1
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 /dr/ /% G/4.�/t-/7L Address
By__ Address
RECORD OF INSPECTION
Foundation Frame / 1 // � �� �,/�
Stucco Finish} /_ `7� 75-344jjt ;f-
1535 Jamestown Drive /
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
is in full force and effect and properly authorizes this application.
San Jose City Business License # I--/0 7/ /
Form 280-1