52469 1116 Elmsford 3o',r3
Tract No.3/90/ Lot No.-?
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT xQBt2L
Date 1 Xz- 4 , 19 e ? Permit No.� 206/
Application is hereby made for a permit to CojiL0.
a I story, Type 'r— Building Use Zone R/-8 L
at . S•T' Occupancy_,r`
to be occupied only as .5 W� Parking Space
in accordance with Plans, Specific tions d Plot-plan filed her with. Fire Sprinkler
Estimated Value of Improvements, $ F
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 #
is in full force and effect and properly authorizes this application.
San Jose City Business License # V. /05-4xj
I certify that in the performance of the work for which this permit pis issued I shall not employ any person
inany manner so as to riolafo the workmen's compensation laws of California.
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