834921468 Primrose Way
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
q APPLICATION FOR BUILDING PERMITQ
Date 9 ` S ' 7_y 19 Permit No.!> J T / 2—
Application is hereby made•for a per to A:gDr «
at
_Use Zone
Occupancy
to be occupied only as/J'4%5T%
in accordance with Plans, Specifications and Plot -plan filed herewith. Fire Sprinkler
Emer. Elect.
Estimated Value of Improvements, $�n/w0i �—
I certify that in the performance of the work for which this permit is issued 1 shall not employ any parson
in any m/�an�0. es vio11late,A�th__e w rkmen's compensation law Ca r I ,
Owner W tete f 0 �'` Address 4 1 m12 r> �/`��yr"
By It I t Address 11 t -- T
y 'NEECORD OF INSPECTION
Foundation - �7 ` Frame
Stucco ' Finish
r.
1468 Primrose Way Wm. Black
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