12191 1085 Milky WAy
S ' g � , Tract No. Lot No.
CITY,,OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date , 19 Permit No.
Application is hereby ma a for a permit to(o�L 2v.-.Q �"
a -�_story T eV �-+ C" 3 i in Use Zone I
at
OOccupancy
to be occupied only a Sq.feet
in accordance with Plans,Spe ifications and Plot- n f here lith. P kiaye�_
Estimated Value of Improvements, $ 71 c7'd"6
61 Emer. Elect.
qq
L�ae of that in the performance of the work for which this permit is issued I shall not employ any person
,mom �tioa4aws.of.California- w
Owner v l Address • ' L
By
Address
This permit shall expire and beco I 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.
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