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Tract No. a Lot No. 36
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date /O 1a3 , 19_6� Permit
Application is hereby made for a permit to -3(At I 'L
a I story pe uil in Use Zone
at .SSa Occupancy
to be occupied only as Fo"' I ti Parking Space 2
in accordance with Plans, Specifications and Plot-plan f* W1 Fire Sprinkler
Estimated Value of Irr ove ts, $�
Exemption from requiro ent a of Cali ' j r c nishereby claimed by undersigned:
as owner ❑ statement filed ❑
Undersigned attests that his State of California Contractor's License # 19 39 4 1
is in full force and effect and properly authorizes this application.
San Jose City Business License #_ -
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.
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