69176 7557 Lockford
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
/APPLICATION FOR BUILDING PERMIT
Date � �^ 16 , 19 z/11' Permit No.-"/ 76
Application is hereby ma;lefora permit to �"
story, Ty p d' Use Zone _ry_1_
S cc�cY
to
#o be occupied only
in accordance with Plans, Specifications and Plo -plan filed herewi#h, Fire Sprinkler —_
Emer. Elect.-
Estimated Value of Improvements, $ '2— U-V-10
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 f/ J Address rr
By�hLj ��s� ds,pn,. Address C3_
RECORD OF
OF INSPECTIO .L 6 •
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Stucco ' Finish
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