53145 ;p— 917 Old Town Ct.
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMEN
APPLICATION FOR BUILDING PERMIT.-
Date
ERMIT.Date / — , !9 & Permit No.
Applicaticn is herreee6y made for a permit tra, _ 7-0
a story, TYPE"' - -rs+--.,Bu'IdI^g,^ ,_ — Use
cup ncy �.� .
at 7 C�/ttl 7—a Cv r7i �`(/�� Occupancy
to Ite occupied only as Parking Space
in accordance witl; Plans, Specifications and Plot plan fiied.herewif, Fire Sprinkler_,_
Estimated Value of liTipiovements, $ �V".�'
Exemption from requ:rernent for State of California for Contractor's License is hereby claimed lay undersigned:
as owner ❑ statement filed ❑
Undersigned aHests that his State of California Contractor's License #
is in full force and effect and properly authorizes A plication.
San Jose City &uiness License #
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.
Ow r
uQl..c� Address 9/7, Oaf r'o Jnl� C!�a 1`�Oar_
i
By Address y701• y„0au,5-s!Ln�.f2� rsnnr s
17 Old Town Cts J.McCullers
RECORD OF INSPECTION
Foundaf ion Frame /�
Stucco Finishr�_ S-S-6 / A40
Form 2001—1OM—5/66