51476 (2) 7834 Robindell
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION F9 R BUILDING PERMIT t`¢
Date %_ 7J O , 19—P <P Permit No.
pplication is hereby _de for a permit to k_ 7-r
a story, Type — Buil ing � Use, Zone � f
at ��3�_� / � OccupancyT
to be occupied only as T wE UC"4'r�� P°rki Space
in accordance with Plans, Specifications and P a ile �n cler
Estimated Value of Improvements, $
oo
Exemption from requirement for State of California for Contractor's License is hereby claimed by undersigned:
as owner ❑ statement filed ❑
Undersigned attests that his State of California Contractor's License , f— J
is in full force and effect and properly authorizes this applica fio .
_ San Jose City Business License #' / 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 to violate the workmen's compensation laws of California.
Owner L/109 Addressf"�'t'��'
Address
By Wim. m v iv f TI 7�5.
7834 Robindell J. Evans �—
99/5-W01-I-0Bi -,-A
9961 6 9 AOM
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