70463-V �A) 8051-53 Park Villa Circle
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CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT �o9v2
Date �Dl/ 19� Permit No. ' 704(, 3
T
Application is hereby made fora ermit to
a Zlb story, Tye -�- Build ng Use Zone
a} �o-3 �DS/ P(�.21 \I t Lt/k eh cLE Occupancy
O$ arking Space
to be occupied on l /� I/
'/ e$ Fire Sprinkler
in accordance with Plans, Speci icat ons and PI }-plan filed Herewith.th./)�
Estimated Value of Improvements, $ djfie
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 vio to the oArn 's compensation laws of California.
Own n/�/a�r/� SEi QFr4✓l_ Address
Address f
RECORD OF INSPECTION
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