17129 §11 j ib6t'ty Court _J
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPART"Flil
P.C.Dae PPLICATION FOR BUILDING PERM �q/`l,6FAv
Date ,19 I Permit No.
Application is hereby made for a permit to
a story Type it t.t_ B Hdi X: Use Zone _
at �l/ 4-"N Occupancy V
to be occupied only as . /—,`a4 Pzy`Wzc ez, Sq,feet 1672
In accordance with Plans,Specification nd ot.pla fit f ere t Parking Space 12—
Estimated Value of Improvements,$ Fire Sprinkler
Emer.Elect. —
❑I certify that in the performance of the work for which this permit is issued 1 shall not employanyperson
Owner N SY&0,16, Address 9/i � ,` Com. ;1•Z,
By1vafal"'4, Address
This Pal sh expire and become null and void if the work authorized by it is not commenced within
120 days from the date issued or if the work Is suspended or she orad for a period of 120 days after
commencement
FINAL INSPECTION � ReveeT78
Exemption from requirement for State of California for Contractors.
Lkense Is hereby claimed try applicant:
as owner statement filed
Applicant attests that his State of California Contractors License No.
Is in full force and effect and properly authorizes this application.
San lose City Business License No.