52469 1'120 Elmsford Zooc-
Tract No.3 l Z 6 Lot No.30
CITY OF SAN JOSE BUILDING DEPARTMENT
C / APPLICATION FOR BUILDING PERMIT ,3/ C
Date l �(7 C 19 6 7 �Permit No.
Application is hereby me or a e mit to r
astory, Type 7 in Use Zoneg f '6 b
a+/IboEI.kSForPl1. pR. y� �� Occupancy 1
to be occupied only as Ei�V �E �" �"�• ✓16/'J /Ca.kir $pace 7
in accordance with Plans, Specifications and Plot-plan filed herewith. Fire Sprinkler
Estimated Value of Improvements, Ii-M.0 a, �6`Nip-
Exemption from requirement for State of California for Contractor's License is hereby claimed by undersigned:
as owner ❑ statement filed ❑ (j-t - 1539 L
Undersigned attests that his State of California Contractor's License
is in full force and effect and properly�yputhori:es this application.
San Jose City Business License # "r •r�'8
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. ST
Owner lPT bJW4-04�S.f 'le A ZnAC• Address .,�7J S NL✓j� j
By
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eoi}epenod
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