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Tract No. 1a.5Lot No. 34
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date 0 .73 967 '�t�Rjrmit No.,-�25 3 ✓
Application i e eo v d.
a_I story, a Building Use Zone AjQ 6-
at 7-S-76 Arvs c,,} lac c Occupancy_
to be occupied pnly as i F0.rr I Parking Space Z
in accordanclyafahs, Specific dyC n f-idf�rewi+h. Fire Sprinkler
Estimated V e(7(7�/oJJ;;''//Improve s,� [ •
Exemption from requirement for State of Case for
CoR Tractor s License 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 a,u/thorizes this application.
T
San Jose City Business License # -/OSh/�?
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 �� e ASSOC-„Q Address 11 7S `]
Address !�
99/5-W01-I-08Z -,Oj
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Z— Z ewe.y uoi}epuno j
NO11O3dSNI dO 48003a