494357799 Lilac Way
CITY OF SAN JOSE @ BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract No ......................Lot No..-------- ..........
Date ........... 3..---17 ............................. I 91a ..... Permit No....
Application is hereby m a for a IpQ
ff 4 416( ry .. .. ......................................
_permi o .
1, -�� Building
a ---- —1 ......... story, Type.]V-1- Z., - — . .. . ....
64-41" --- - "
at .771.1------ .......................... —k , ..........
� ..
1h I �7Use Zone
-------------
�*;Iar �inop
to be occupied only as M ....... -
in accordance with Plans, Specifications and Plot'plan 41M�erewith.
Estimated Value of lm;rovements, $ ...... .................. dee 20, ao
It is hereby agreed that the requirements of the San Jose Building and Zoning Ordinances and all other laws
applicable to the construction, location, and use of buildings within the City of San Jose, will be complied with.
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 workman's compensation laws of California.
Contracto
ByAgent.......' --------Address..... ...... ... .........................
7799 Lilac 0 Norris—LEfiquist or,
RECORD OF
FG. M _ 7, 6
1• Y
FOAM 2801 -IOM -2/85