87923Tract No.
CITY OF S N JOSE
APPLICATION
Date V I t
Application is hereb mady% for a
a story, Type-
to be occupied only as/ n 0.
in accordance with Plans, Specifications
Lot No. USC 1471.
BUILDING DEPARTMENT
FOR BUILDING PERMIT
Use Zone
Occupancy
rking Space
ire Sprinkler
Emer. Elect.
Estimated Value of Improvements, $ 0 '
I certify that in the performance of the work for which this permit is issued I shall not employ any person
in any me er so to violate the w i�men's compensation laws of California. �G
Owner �h 7y� Address 74k
By Address
RECORD OF INSPECTION
Foundation p Frame
Stucco _ Finish
8081, PARK VILLA CIRCLE PONDEROSA HOMES
Exemption from requirement for State of California for Contractor's License is hereby claimed by applicant:
as owner ❑ statement filed ❑
Applicant aftesfs that his State of California Contractor's License #
is in full force and effect and properly authorizes This application.
San Jose City Business License #
Form 280-1