50962 959 Nov Tract No. Lot No.tuber
CITY O7/ JOSE BUILDING DEPARTMENT
APPLICATION F1;BUILD NG PERMIT
Date' - 19 - ermif No. ,
Ap icafion is hereby made fora permit to
a
story, Type / Building Use Zone �-
af J r D r ;L4 Occupancy
to be occupied only as r( ✓ No L Parking Space
ti Fr
in accordance with Plan , Specifications andJ�t®pilan fil�� h.4 Jire Sprinkler
Apr
Estimated Value of Improvements, $ ODO
Exemption from requirement for State of California for Contractor's License is hereby claimed by undersigned:
as owner ❑ statement filed ❑ &.5-3 Q
Undersigned attests that his State of California Contractor's License # / 96 /7 /
is in full force and effect and properly authorizes this application.
San Jose City Business License $k— ��
I certify that in the performance of the work for which this pormit is issued 1 shell not employ any person
in any manner so as to violate the workmen's compensation laws of California. ,f ' �`
Owner /��L� - k6.4 r)a jol Address_—9 AkV eA `✓r°2 LYe
BY ( Address�0
A9 Novembe _ William Hadfield
99/S—W01—I OBZ w�oj
9M S T AOM
4slul on4S
BW@.LJ 3rZ ^ . 1}PPUOOj
NO1103dSNl d0 480038 �/