70463-Y (2) 852-54 Park Villa Circle1000
Q 0 Lot No. e�/5/- @oN T1+*� �9�
� 1\1 Tract No.r��
CITY OF SAN JOSE BUILDING DEPARTMENT
APPOCATION FORS-0 ILDING PERMIT
Date �CTDB� <2i i� cI'9� fLPerm�MNo.
lication is here made for a permit to o/G,O
a stor , Typed �t Buildin Use Zone
at y `� �� �cLC/ �� Occupancy
to be occupied only a -g% iL �e/king Space —
in accordance with Plans, Spteciffc ons and Plot-plan f' d he : i+h. Fire Sprinkler
Estimated Value of Improvements, $3D OLIO°� rZE7 3963E
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 o viol to th�e��`°rkmen'j compensation laws of Califor ie.
Owner
42, -03, ' 'n/rSf �lViq Address - -i6;_ 5-
By �l 41Z-e/ W—A, - Address _ _
7
RECORD OF INSPECTION
Foundation �� l / '" - Frame A A4f- 700-A �I-1,,/� 121
Stucco Finish�' /3' ' 2'
Co Att4,
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 .j{'_�7`sf
is in full force and effect and properly authorizes this application.
San Jose City Business License #
Farm 280-1