70463-V (2) 8121-23 Park Villa Circle 7e7_
Tract No. '669 y o Lot No. :5 - K
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT 70922
Date /y��Z'����' 19� Permit No. FI«v o14 6 3-
Application is hereby made for.'a permit }o ��L IL
a story, Type � Building Use Zone —�—�
a+�2 3 ��L i9rP 1/i GLA C/�0-/,c Occupancy
to be occupied only as �_P,A�glSpace�_
in accordance with Plans, Spec ice ions and Plot-plan filed herewi}h, Fire jp, ler =-
Emer. Elect.
Estimated Value of Improvements, $ ,, DOD °D 16:7,/-�?_�
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 4o violet the workmen's co ansefion laws of California. ,�7.,
Owner �T S /HSC ddress �� D5/#rs /i/ ALO L,
By �Q� ` �C/.�a Address
RECORD OF INSPECTION
Foundation 3- jam,' '��
Stucco Finish �� �' 7 2-
coW P 4 551
Exemption from requirement for State of California for Contractor's License is hereby claimed by applicant:
as owner ❑ statement filed ❑ -1141 �
Applicant attests that his State of California Contractor's License #
is in full force and effect and properly authorizes this application.
San Jose City Business License #
� - q3
Form 260-i