56205 7585 Holla deny. 5, g �
�ract No.�� Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
''//
APPLICATION FOR BUILDING PERMIT L_
Date— _
91_ / 7 , 19 Permit No. ? Z
Application is herebo made for a permit to ADD rM d G( X�`! �2aai1_
I
a_�story, Type _ _Bwlflm Use Zone �
�� Occupancy
to be occupied only as ��� Parking Space Z
-Spe i fi W1Wle p ''f+( /h4e�. Sprinkler
in accordance with Plans, S e ifications a +- la e e
Estimated Value of Improvements, $
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 e t violate the worken's compensation laws of California., //
Owner 7 Sr S Address o , ar
By-
Address X79 17
RECORD OF INSPECTION
Foundation �— ` %� Frame 4_7 fc!F
Stucco 3— 7 C9 Finish
,roc V i � fl r�A, 9 D. Carmody
Exemption from requirement for State of California for Contractor's License is hereby claimed by applicant:
as owner ❑ statement filed ❑
J r
Applicant attests that his Ste- of California Contractor's License �{' / 6 t�
is in full force and effect and properly authorizes this application.
San Jose City Business License # ` / � 5;;7
Form 280-1 Re, 4/67 IOM