53369I. 7483 Dumas
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT'S
Date ...5�—�Z 19 j�7 � /� Per it ,No.
Application is hereby made for a permit to �� y.V It�'�+-ens
a I story, Type_ldd'i g Use Zone k _I
at/!/C/ Occupancy___
to be occupied only as �� Parking Space L
in accordance with Plans, Specifi o f 'nd PI a fil ^eretvith. Fire Sprinkler
Estimated Value of Improvements, oo — 4rl
Exemption from requirement for State of California for Contractor's License is hereby claimed by undersigned:
as owner e-- statement filed ❑
Undersigned attests that his State of California Confrec!or's License #
is in full force and effect and properly authorizes this application.
San Jose City Business License #
I certify that in the performance of the work for which this permit is issued I shall not employ any person
in any mann'— so as to vi atetheen's compensation laws o'�fofn:e.
Owner G / Address , Ov�
By Address
7483 Dumas 9 Donald c. Pies
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