70463-V8W-31 �Park Villla'.Circle I tfm1rd3oo
Tract No. czo `-� e Lot No. /
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Dafe —&=eAr-3-9 7 , 19 %/ Permit No. iOT
pplica+ion is hereby made for a permit to
a _ s+ory,TyeBuilding Use Zone —/
at S /3/ ¢ /L�%�9�%i ,/L[y% �//LozG Occupancy
to be occupied only a e I �'a�'"�--
,ti Ire�Spri kle�
in accordance with Plans, Specifica ons an lo�planrfi �herewi
O
Estimated Value of Improvements, $ re)o39D3f-
I certify that in the performance of the work for which this permit is issued I shall not employ any person
in any m�%'er so as o violaLfe�llow Omens ompansaiion lows of Califon iOwner/�/ _ .Y/Addressgy_`2V -=`2 Address".
RECORD OF INSPECTION
Foundafion�.Q /ice � t�-+-�•.7-*-� Frame A
Finish —1Xr 72- A4L_—
c01uP':(1's"S(6
Exemption from requirement for State of California for Contractor's License is hereby claimed by applicant:
as owner ❑ 0a4ement 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 #
94%
Form 260-1