87923 8127 PARK VILLA CIRCLE
Tract No. Lot No. !!'' r, �f„_
CITY OF SA JOSE BUILDING DEPi4RTIjAENT
APPLICATION FOR BUILDING PERMIT
y1
Date 19—L�/��ermi# No.
Application is hereb adp for a permit to L$Pir/\ J�7/ nw I
s+cr Tyke Build ng, � Use Zone
at_f e - 7__ / / ��./i _•P „ I Occupancy
to be occupied only as Q( � Parking Space
-t ,r Fire Sprinkler
in accordance with Plans, Specifications and Plo#- 'Ian filed herew'tli./ /S_0
�} .1 /j//��ly/�E�,Elect.
Estima+ed Value of Improvements. $
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 as violate the work compensation laws of California.
Owner — —j�� J Address
By Address
RECORD OF INSPECTION
Foundation Frame
Stucco 9,1y' )�-Aao(s Finish
8127 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 290-1