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Tract No. 4aSll . Lot No. 30
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date /0423 , 196L Permit No. 5 S 5-3jL,V
Application is hereby made for a permit to
a_Istory, T pe t r ilei g Use Zone
at `1lo2�v Occupancy
to be occupied only as I Gvs, I Parking Space 7—
in accordance with Plans, Specifications and 1pf-plan filed ewith. Fire Sprinkler /^
Estimated Value of Improv �n , 10 C /
Exemption from requirementalif f o r' 'fha a imud by undersigned:
as owner ❑ ��st filed ❑ �/ _
Undersigned attests that his State of California Contractor's License # ! 939
is in full force and effect and properly authorizes this application.
San Jose City Business License # 4 -ios`�8 '
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. 1'
Owner . �. Nk e r ASS oe. Address 1 19S $. f wv . 9
gy 7 , Aiii� C� Address
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