54421 A Tone
Tract No. Lot No. 9
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date 1967 Permit 6. -5-
y zZ /
Application is h reby made for a permit to 3K i /d
story, Type_ B ity) ,(�) Use Zone'
at /S, q1 14s Occupancy_
to be occupied only as / EG ?vv; Parking Space Z
in accordance with Plans, Specific o nd Plot-pla file a ith�:''F1B Sprinkler
Estimated Value of Improvem� �/Y
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 # 13-1
is in full force and effect and properly authori:os ;hiSs appliyci?n.
San Jose City Business License # y �O ° '
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 riolato the workman's compensation laws of California. _
Owner -7ec-I - S'T- 5 7Z ciclress ,&?S
BYE Address
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99/5—W01—1-08Z w,oj
(2 O 9G4 --31'
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