71236 7500 Dumas Dr.
Tract No. Z/6 7 Lot No. ;7 2-
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date �" �� , Ig72 Permit No.7�-2�� �hrN
Application is hereb i a for a ermi _,to 0
a__story, T pe. _ � g Use Zone •�— /
a+ 0 _sr_n ./' �' -`�_ �//Occupancy
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to be occupied only as Fire
Space Zre S'� ` prinkler
in accordance with Plans, Specificati s and Plot•pla%filed herewith. re S Elect.
-
Estimated Value of Improvements, $
COQ .
I certify That in the performance of the work for which this permit is issued I shall not employ any person
in any manner s as to violate the workmen's compensation laws of California..y-�
Owner s Address 7SPC) Y G A,- �S ( w
By Address /d9_e 7
RECORD OF INSPECTION
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