86184 81L7 Hyannisport Dr.
Tract No. 3 4-aa Lot No.=1�c�
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Dafe A P P_1 l_ k 5 1197,5 Permit No._
Application is hereby mad for a per .f ' +
a story, Types W t i Use Zone
af8 4 ANN R-T C)9_ Occupancy
f be occupied only as �pP_I VA��,�1 �� rking Space
Fire Sprinkler
in accordance with Plans, Specifications and Plot-plan filed herewith. Emer. Elect.
Estimated Value of Improvements,
$SInOo , 00
I certify that in the performance of the work forwhich this permit is issued I shall not employ any person
in any manner so as to violate the workmen's compensation laws of California. PQ Q. D/
Owgerg S w F�L-GZ0K Addressg 147 NyA M)ln T 1
ByAIb( lPPL ook_ Addressg2BC ,�t<fkfyl(1U0R �QL
RECORD
OF INSPECTION �"t"°"yv"`t
Foundation Frame
Frame
Stucco Finish n /D— 30 —
Exemption from requirement for State of California for Contractor's License is hereby claimed by applicant:
as owner ❑ statement filed k3 �j
Applicant attests that his State of California Contractor's License # oL<D
is in full force and effect and properly authorizesthis application.
4—SSan Jose City Business License # S O0 cVa 3
C.H. 1S- Nu 7E Ony GA 76 "INSp oK- To Gu iN Ztrdv-7
iAJ �Nc DUGSfN $ACKY14t0, AIc6,0C47C.yfC4LoS6K
^f 04 7.ES
Form 280-1