16970 7888 �46di6llAh Road
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
P.C.pate APPLICATION FOR BUILDING PERMIT /
Date —'/'sh`L uE / , 197`j Permit No.
Application is hereby made for a permit to A 17�7z io2 "
a _story,TypeBuilding Use Zone -
at 7 5 eD GZ/-- CLcct�uJ Ro,f 0 Occupancy 64 3
to be occupied only as 427eq6,1.1V-1,Z' Sq.feet
in accordance with Plans,Specifications apd Plot Ian filed herewith. Parking Space G.��
Estimated Value of Improvements,$ / 6'0 Fire Sprinkler
Emer.Elect. t J CJ
❑I certify that in the performance of the work for which this permit is issued 1 shall not employ any person
�Ownew AddresslaleC2 M c.GI lo. �aw• K.X_
By Address 13�-"s
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. f�
FINAL INSPECTION 280.801Sµ78
Exemption from requirement for State of California for Contractor's.
License is hereWclaimed by applicant:
as owner m/ statement filed i
Applicantattests that his State of California Contractor's License No.
Is In full force and effect and properly authorizes this application.
San Jose City Business License No. -Cy
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1.