50634 7491 Dumas k)/I
Tract No.Zr� Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date /_S Permit No.
# n
plicais hereby made for a permit toy}�ye
a story, Type Buil in Use Zone
a# 7 e.1 Occupancy
to be occupied only as__j-02.—/--jvp{�2A/ XFirarke y Space
in accordance wi#h a to
Plans, Specificatio e Fire Sprinkler
Estimated Value of Improvements, $
Exemption from requirement for State of California for Contractor's License is hereby claimed by undersigned:
as owner ❑ statement filed ❑
Undersigned attests that his State of California Contractor's License # S 33 yj
is in full force and effect and properly authorizes this application.
San !oso City Business License
I cerfify that in the performance of the work for which this permit is issued I shall not employ any person
in any manner so astp folate the workmen's compensation laws of California.
Jo '
Owner - 4w/ Address_7�9/ y'�--
By jgc F �„ ti�� ��,_Address 4-3,t- 2Z �=
7491 Dumas John Lindberg
99/5—Wol—I'o8i .,.j
I+fl{n j oo*n+S'
�f ewaid o!+ uno j
NOIAOUSN1 d0 4mom