67622 821 Betlin Drive
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date , Ig 7/ Permit No. 7622
A plica#ion is hereby made for a permit to
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A-1—s+ocy, Type _ Building Use Zone
atm f Occupancy �--
J� irking Space
to be occupied only as q.
/ Fife'Sprinkler
in accordance with Plans, Specifications and Plot-plan filed herewifh.
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Estimated Value of Improvements, $ 500
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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Address � �r a P/GrgH
BY �4 s w Jorma
RECORD OF INSPECTION
Foundation Frame _
Stucco Finish
821 Betlin Drive C . Ludlow
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