70463-Y 8084-86 Park Villa Circle min /T7-4
Tract No.1:5G41O Lot No.� 'o
CITY OF SAN JOSE BUILDING DEPARTMENT
� APPLICATION FOR BUILDING PERMIT
Date_�L� �/ 7 , 19-'4 ,Per i+ No. U
Application is hereby made•.for a permit to
a��
p( story, Type �/>/ ;-l 9Building Use Zone
at O OB'� -10, ilk. Lf} 4 CCG t ;Occupancy_f}.
rarking6Space�
to be occupied only as
V kn� �/� F' a Sprinkler
in accordance with Plans, Sa ca ions and Plot-pla U d he with. r7�_3-�D
Estimated Value of Improvements, $ --;50 9)00 Q� RD'S 39z'Sb
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 astov-iolate/Ie work en's cop/pensation laws of Californig�
Owner_ 9 �/�r�!.vr T/ "�i/�c ddress C�i/'G�1'S
gy __1 c l Address ? O�
RECORD OF INSPECTION p
Foundation Frame .1-12- 7'2— �d2vi-a--•-<<1
Stucco Finish 71 / L , 2
0o V'Pr S-:5 2 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 #
is in full force and effect and properly authorizes this application.
San Jose City Business License #
Form 280-1