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Tract No. G18 Lot No. l 7
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING�P�R I Tf
Date _ 6 19 -7 8 Permit No2l 0 �}�OP
Application is hereby made for a permit to C ( 1. (A-T 2 C� `
astory,Type — i i `r G f Use Zorie �
at Occupancy
to be occupied only as Sq.feet S
in accordance with Plans,Specifications and P - Tw�filed her it king e
Estimated Value of Improvements, $
Emer. E ect.
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.
Owner MRI-M29 MCCULLOCH Address 7/��I �t�L 1 �7 C"i A`- �G,,PQ-arc'_
B S L �— — Address
Y
This permit shall expire nd 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.
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