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Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date 7— 2! , 19?A Permit No.
Application is hereby made for a rmit to eEAi 4e
story,Type iaB _ Use Zone
at //yp�3j�cV/C// Occupancy
to be occupied only as Sq.feet
in accordance with Plans,S ci tionsd.hereJ�'ith. Parking Space
Estimated Value of Impr , $ l G Fire Sprinkler
Emer.Elect.
1 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.
OwnerAddress
By Address 2a �� a
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 280-601 N
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