62229 1151 Kentwood Ave
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FORBUILDINGPERMIT
Date z 19 / Permit No. � �7�Z�
Application is hereby made pe it t Srok
Lr
. astory, Type ? E Use Zone
at /ISI Ysc�I'f'/u'�02-- �� ' �/ �f/��'�� Occupancy
to be occupied only as �vv' /6 Parking Space
in accordance with Plans, Specifications and Plot-plan filed herewit .
*Fire Sprinkler
Estimated Value of Improvements, $-1c0o D
I certify that in the performance of the work for which this permit is issued I shall n trteerriploy any person
in any manner zo e
wners to violate the workmen's compensation laws of Calif rote.
O _
.�� �— Address
By Address SS
RECORD OF
INSPECTION
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