87923 8086 PARK VILLA CIRCLE
Tract No. Lot No.
UBC 1973
CITY OF SA JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT�/ c M1
Date Z 197 ' Per it No. ° / L.3 i 00r�
Application is her ma e f r a permit to « ��
e stor T e Building Use Zone
Occupancy—
to be occupied only as 7)�? 144-,C— �^ �f Pang+Space
I�/(/F`re Sprinkler
in accordance with Plans, Specifications and P.lo+plan fi.ed herewi#h. Em�Elect.
-
I
Value of Improvements, ; 0
I certify the+ in The performance of the work for which this permit is issued I shall not employ any parson
inany me r so as o violate the workme 's compensation laws of California. �`
Owner— `� _-�' -�fq .A'Address — !/`
By Address
RECORD OF INSPECTION
Foundation /� Frame
2
Stucco ' 7i/ — 7 J „Finish
8086 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 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