77219 875 Liiy Avenue
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Da#e19rmif No. 77a/ 9
Applica+i n is hereb mad fora oermi+ to
a stor T e Buildi g Use Zone
at RO � OccGpancy
to be occupied only s eying ace
in accordance with Plans, Specifications and Plot-plan filed herewith. Fire Sprinkler
_ � Emer. Elect.
Estimated Value of Improvements, f1�2J®
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 vjolate t e workman's compensation laws of California.
Owner T_ <4.?sN t 31 Address
By_jC1. F- Address 7
RECORD OF INSPECTION
Foundation Frame .
Stucco Finish to " 3-7-3
975 Lily Avenue J . Cunningham OvAIC
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