10164 82G September Dr.
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date L� a lig 74�' Pert No/ !o
Application is hereby made for ermit to c1 to
a --/—story,Type �� a Buil in Use Zone s
at Sf R6 5e h K. Occupancy
to be occupied only as ',(z`;q..n ge--2 Sq.feet 3r
in accordance with Plans,Specifications and Plo filedrewi Par $S�pace
Estimated Value of Improvements, $ D drfnkIer
Emeer. Elect.
I certify that in the performance of the work for which this permit is ffissued 1�ayp not em o person
Owner c� CSS' SA�e Address gab Se I'y jer ��
i
ey 'Address –7014c�
This permit shall expire and become null and void if the work authorized by it is not commenced within
120 days from the date issued or if the work is suspended or abandoned for a period of 120 days after
commencement.
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WHITE-FILE YELLOW-INSPECTOR PINK-OFFICE