70463-Y 8101-03 Park Villa Circle 6-3—
l3=
rVg � Tract No.� Lot No. ���
CITY 0 SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT -709z?-
Date
o%zzDate ��y' 19 Permit No. 7�rc-t-N :2
Application is hereby made for a permit to e
aTGyo story, Type ��� Build nig Use Zone
at3 /D�_A/��/L �q /Q�' Occupancy
to be occupied only as F,ire-
in accordance with Plans, Spec ications and Plot-plan file' h rewifh. Em re . Elect.
Estimated Value of Improvements, $ �npznDoO
L .
I certify that in the performance of the work for which this permit is issued I shall not employ any person
in
any ma nar so as to violate the workm n's compensation laws of California.
own n/M �✓On c �v sFeAddress / y�Ti� 1027
gy f7QGfr�l/ Address
RECORD OF INSPECTION
Foundation ('—/7' 72 zAi" ....-.tea_. Frame
Stucco Finish 2— L
Cp lu-,,0* ss-1-3
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 appli:ation. /
San Jose City Business License #
Form 280-1