529691132 Elmsford L
Tract No. 1Zv Lo{ No. U 3
CITY OF SAN JOSE BUILDING DEPARTMENT
/- L APPLICATION FOR BUILDING PERMIT
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Date 6 e , 19 G 7 Permit No. LZ4'j >7
Application is hereb made for a permit to i "t
a A story, Type � Id' Use Zone le h 0 G
at I JR ' �(/ Occupancy. S
to be occupied only a - t S• Parking Space y
in accordance with Plans, Specifications dd I n ile a ` h ire Sprinkler
Estimated Value of Improvements, $ !I Otl�' Frf'� S
E+empfion 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 # 7
is in full force and effect and properly authorizes this application. O
San Jose City Business License # j% —1 ST
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 orkmen's compensation laws of California.
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