92776 8084 PARK VILLA CIRCLE
UBC 1973
Tract No.— Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT �/ 72-
D
L ,
Date_;—� � , 19.Z- Permit No.��_L
Application is hereby madeo'fbr a mit to / ' 'T S
_ % 57 �-- Use Zone �.Q
a--1 story, T e / / Building
a+� �!E! 4i�.y �]f���f/ Occupancy
to be occupied only as' /`2� yir4O ' 14 4 SPace
Fire Sprinkler
in accordance with Plans, Specifications and Plot-plan filed herewith. Emer. Elect.
Estimated Value of Improvements,
1 certify that in The performance of the work for which this permit is issued I shall not employ any person
ineny mann somas •To viole}e the workmen's compensa}ion laws of California�
Owner_/_.—LZ�/_ll �� Address-
Ely
Address
RECORD OF INSPECTION
Foundation Frame
Stucco Finish
260-601N
' 80.84 PARK YILLA. CIRCLE _ ---_.--------.. -.-
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 #
is in full force and effect and properly authorizes this application. ,
San Jose City Business License #
280-601 N