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Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
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APPLICATION FOR BUILDING PERMIT Bv'o
9
Date - t , 19 7 Z
7 Permit No. ��s_ 7
Application is hereby made for a permit to
a —2 story,Type f7_ Building Use Zone AC
at 5e55- ,17 C)GC./,U(-Gla eo / IA-n,m c E,,3 cupancy --7-- _
to be occupied only as / F,4A4 l,c4114WOW ;A/ 6,4! Sq,feet
in accordance with Plans,Specifications and PI&Ian filed herewith. Parking Space Z
Estimated Value of Improvements, $ /GO Fire Sprinkler
Emer. Elect.
1 certify that in the performance of the work for which this permit is issued 1 shall not employ any person
in any manner so as to violate the workmen's compensation laws of California.
Owner C �Q N 1 )C' �. Address ssss. I&LL tK e.M- kte71A
By Address
This permit shall expire and become null and void if the work authorized by it is not commenced within
120,days from the date issued or if the work is suspended or abandoned for a period of 120 days after
commencement.
FINAL INSPECTION 260601 N
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