56053 7537 Prospect
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Tract No. / Lo} No.
CITY OF S N JOSE BUILDING DEPARTMENT
APPLICATION FOR LIILDING PERMIT a` �
Date/ Z S , 19 �_P it No. S6OS3 #
Ap Iication.is here a for a permit' „"
a story, Typ Buildinn9 �j� Use Zone
at' .3 os j�& Occupancy •l
to be occupied only as — 4 "`7 ParkingSpace- t
in accordance with Plans, Specifications and Plq f-plen filed,h�wifh.9'V 64—inr
I Estimated Value of Improvements, $fir
I cerfify that in the performance of the work for which this permit is issued I shall not employ any person
in any ma ar a}}J��o violate the workman's compensation laws of Califor�n'`'. g
Owner, - f (vO k/Te/i Iso C' Address
y 3 � , �< Address
B RECORD OF INSPEUCTION
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