51121 7549 Neur"Castle
•;Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date Ot c 9' c,2 , ig C� Per it No.S// 2 L
Application is here y made for a permit to 4 1-Q�
a_story, Type .Z X Use Zone
at 77 v9 17.GW !° r Occupancy#o lee occupied only as J�L'j P24'� RParking Space
� in accordance with Plans, Specifications and to - an filed her wrt
Fire Sprinkler
-
Estimated Value of Improvements, $ 6'
Exemption from requirement for State of California for Contractor's License is hereby claimed by undersigned:.
as owner statement filed ❑
Undersigned attests that his State of California Contractor's License #
is in full force and effect and properly authorizes this application.
San Jose City Business License #
I certify that in the performance of the work for which chis permit is issued I shall not employ any parson
in any manner so as to violate the workmen's compensation laws of California.
OwAddner T F1 Address
By
7549 Gew Castle I .T. Graham
99/5-W01-I-OBZ w,04
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