50855 7950 Crpnberry Circle
Tract No. Lot No.
CITY OF SAN JOSE i BUILDING DEPARTMENT
APPLICATION F R PUIDING PERMIT 4k
Date 19 �-
Permit No. �'SG S
Application is her
cebb made for a permit tol'}(7_O 0 6,y �L �
a_Lstory, Type. V in �`� Use Zone le
of +IZCCG Occupancy
to be occupied only as _ % Parking Space L
in accordance with Plans, Specifications ° Ian iied le eewi Fire
S�prinkler
Estimated Value of Improvements, $ C���L�E��/Li/ / /l
Exemption from requirernent for State of California for Coniracior's License is h eby claimed by undersigned:
as owner statement filed ❑
Undersigned aftests that his State of California Contractor's License #
is in full force and effect and properly authorizes this application.
San .bse City Cusiness License #
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 violafo the workmen's compensation laws of California.
Owner' .- Address�/��"'���
By �)i, y��� / Address
7950 Cranberry Cirlce D. Miller
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