54768 159MAWr Lane
Tract No. 44W1 Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APP ICATION FOR BUILDING PERMIT _ --5 a
Date a , 19� Permit No. .7 g-76,P
Application is hereby made for a permit to /34 , A/
a_Lstory, Type -,0- �qPS. Building Use Zone
of _ ill Occupancy i
to be occupied only Parking Space
in accordance with Plans, Sp ;cations and Plot-plan filed herewith. Fire Sprinkler
Estimated Value of Improvements,
Exemption from requirement for State of ona or i is hereby claimed by undersigned:
as owner ❑ statement filed ❑
Undersigned attests that his State of California Contractor's License # 939 G/
is in full force and effect and properly authorizes this application.
San Jose City Business License # lel �t7 r ✓ '
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 violato the workmen's compensation laws of California.
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