73629 7925 October Way
Traci No.- Lot No.
CITY OF. SAN JOSE BUILDING DEPARTMBNT
APPLICATION FOR BUILDING PERMIT I''fd
Date 19 7'Z Permit No. -7 3 6 Z9
Application is heti made for a permit to k4ldr 7`0
a r story, Type BuildingI el I Use Zone C— ; e'�/
at279e7S�Ls70bE2_L I /(/ Occupancy
OO� Parking Spacey
to be occupied only aslu rt
in accordance with Plans, Specifications a'nd Plot-pla sled herewith. Fire Sprinkler
♦ E er. Elect.
Estimated Vblue',of Improvements,
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(,:A/A2t-/As SEe.t¢2s Address79A4S�" k)A_� ,4"7r 10
By A, a. -JEa- Address -511L S. dAscowk..
RECORD OF INSPECTION
Founda#ion. (J Frame
Stucco Finish •��
7925 bctober Way 9 C. Sellers
Exemption from requirement for State of California for Contractor's License is hereby claimed by applicant:
as owner ❑ statement filed ❑ QQ
Applicant attests that his State of California Contractor's License #—r, I / D1 4
is,in full force and effect and properly authorizes this application.
San Jose City Business License #
L T T G W R?E C�U ES T,
Form 280-1