53549 7951 Folkstone
Tract No. 3/ a� Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT �9
Date 5--2, 3 , 1967 „ llermit No. -5 -3S
Application is hereby made for a permit to xa.
a__story, Type uilding Use Zone.—
at S�� Foil< T+ � Occupancy
to be occupied only as , �/� Parking Space 2
in accordance with Plans, Specificafio�y n6 of-pl iled"hefev re Sprinkler
Estimated Value of Improvements, $ /1, 000
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 # 4
is in full force and effect and properly authorizes theirs�japplication.
San Jose City Business License #'�—�OS[^
I certify that in the performance of the work for which this permit is issued I shall not employ any person
iola the workman's compensation laws of California.
Owner vin any manneryo as IZAddress 1rs 4 F-
B
By sp' V'e Address fie-Q 44
RECORD OF INSPECTION
Foundafion " C ,�G !g Fra
Stucco i`F nish /a ' �/• G 7 QGy�
Form 2801—10M—5/66