54721 LVV J er Lane'
Tract No. 4 S-41 Lot No. 1
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING,: PERMIT
Date_ 19_(7 �Permit No.
Application is hereby made for a permit to u r
• I story, Type v uil, ' � Use ZoneliL'SZ�
at 'r Occupancy L
to be occupied only as — Parking Space
in accordance with Plans, Specific7>$H%1
# to#- n fjd h rewi#h Fire Sprinkler
Estimated Value of Improvemen$!, $ �/� •�
Exemption from requirement for State of California for Contractor's Licons is hereby claimed by undersigned:
as owner ❑ statement filed ❑
Undersigned 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 # y— X07' 4(t—
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 �� sSoa = Addresses
Bi� n Address
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99/s—Wdi—I-08Z .,.I
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