70463-V E31,76-78 Park,'.-Villa Circle- , /6fpiniT— o
/I�17 1 Tract No. Lot No. �3/r
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date /_�?� 72 i g Permit No. 7 0 4 3—
IG
Application is hereby m�adiee for a permit to zezeZ
a. �_st r Type v��` � Buildin —�+ Use Zone
at XO75 �07G /�9 C i/ �/ �`LOccupancy
to be occupied only a 6 'oParking Space
ppts L�t'3t ,/� Fire Sprinkler
in accordance with Plans, Sp€ci ica ions and of-plan sled he with.
0 odd ��� 3t
Estimated Value of Improvements, $_��� n a /. r 39B3v
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 vioIIeAthe ;kmey� compensation laws of Cal/ET1/� Addressi Address
/[RECORD OF INSPECTION
Foundation//IlFrame �— ��' 7� �/1"e.•ya'�r'�'f�i�
Stucco Finish I 2r 2,
couc� ssz 2.
Exemption from requirement for State of California for Contractor's License is hereby claimed by applicant:
as owner ❑ statement filed ❑
Applicant attests that his State of California Contractor's License # /7`/`-/0
is in full force and effect and properly authorizes this application.
San Jose City Business License #
Form 280-1