17353 7817 biftdr
Tract No. ] � Lot No.
CITY OF SAN JOSE BUILDING DEPA MENT
P.C.Date APPLICATION FOR BUILDING PERMIT Q .
Date 6-13 , 19 P rmit No. F.1�srw
Application is hereby made for a permit to /DAG X/SiL y i // �dS�B
a �_story,Type inse Z
one :/1-L
at ccupancy
to be occupied only as G E S->2y-79 Sq.feet ��a?
in accordance with Plans,Specifications an lot pI ed herewith. Parking Space
Estimated Value of Improvements,$ n
Elect.
rmdl
D I certify/that in the performance of the work for which this permit is Issued 1 shall not employ any person
Owner U. to / Yk-/t RIre, Address :Z /7 /�Gtn Qr C� .Soi oa e
By �.7.0,a, P, Address
This permit shall 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 abandoned for a period of 120 days after
commencement. / ///'/l/�q-�•
FINAL INSPECTION (0`/3-7'1 /)A.tuLIiyLP.Pi /d�1C 1.1� 28t180't,tJ78
Rev. t3/
i
Fxemptlon from requirement for State of California for Contractor's.
License is hereby aimed by applicant:
asov statement filed
Applicant attests that his State of California Contractor's License No.
Is in full force and effect and property authorizes this application.
San lose City Business License No.