51105-F 1523 Jamestown
Tract No. 320 i Lot No. 3
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date Permit No. 5-
Application
Application is hereby map. for a permi to
a story, Type it Use Zone
at /SZ 3 & TnwOccupancy
to be occupied only a - Coo✓ /,fj/W_/ V yParking Space Z
in accordance with Plans, Specifications and/Plot-plan filed herewith. Fire Sprinkler
Estimated Value of Improvements, $
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 # -Z 3 2 5e
�is in full force and effect and properly authorizes this application.
San Jose City Business License #. y— w a y,.r
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 workmen's compensation laws of California.
Owner�it �f' /h`' Pb n r' Address Z-' -2,9 /A -T a, 129 S'.r
By A/,,... . /.. - Address // Z+—�12�4 3/_ TCS
1523 Jamestown Ray K. McPhails
RECORD OF INSPECTION
Foundation Frame)
Stucco
Form 280-1— OM—5/66