675388085 Hyannis Port
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
^° APPLICATION FOR BUILDING PERMIT _ 2
Date-/ -.19 71 Permit No. 7.5 3
�pli tion is herebmade for a permit to ADD r0
a -2 --story, Type it r Use Zone
at O STup/ / ccupancy
O rG� Parking Space
to be occupied only as �� E� ov Sprinkler
in accordance with Plans, Specifications ap P an
Estimated Value of Improvements, $ O(r) 2
I certify that in the performance of the work for which this permit is issued I shall not employ any person
in any manner r Ifo violate the workman's compensation laws of California. i
B wner ' / _ aL2'LQ�� Address ' pp
Address I_�4-77 t�c&nf2Z`�--
RECORD OF INSPECTION
lrou ndation cl '��-"� Frame I' �2- 2/�S�e� f�
Stucco o� c�-G _ % „""-'� Finish 3 - ol-4 7 e 1 �
` n
Rf1R5 Hat P
ynnis PnrrKimura
Exemption from requirement for State of California for Contractor's License is hereby claimed by applicant:
as owner ❑ statement filed ❑ / l /— q
Applicant 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 # 4/ —
r ,
Form 260-1