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58294 F 7639 Prospect
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
/ APPLICATION FOR BUILDING PERMIT �
Date_,.// 19 Permit No. Sf�'Z9¢ l
Applica# is hereby made for a permi4
a—/—story, TyyP�a _ i Use Zone
at Occupancy C
to be occupied only as � $pace
in accordance with Plans, Specifications an -p a fed erewi# , rinkler
Estimated Value of Improvements, $ z�Ole©
I certify that in the performance of the work for which this permit is issued I shell not employ any parson
in any men as to vi late the workivei s compensation laws of California p
JOwner _ Address 7..��9 P h d S•S-
� Address (/
By /'pn Ati y_ia-G DL..J
RECORD OF INSPECTION
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