72605 6275 Shadygrove Ct.
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Da#e 5— �r , 19 7 z- Permit No.
Application is hereby made for a permit to I TO
a story, T pe'1Z _ (2 it 'n Use Zone
at ? Occupancy
to be occupied only as Ptkf _ I > _( 7f
F W& Parking Space
in accordance with Plans, Specifications and Plo � ler
r I
Estimated Value of Improvements,
I certify that in the performance of the work for which this permit is issued I shall not employ any person
in any mapper so as to violate the workman's compensation laws of California.
Owne / C !� ���
Address
By Address ,/O a 7 P
_M RECORD OF INSPECTION yZ
Foundation Frame
Stucco Finish
6275 Shadygrove Ct. P. Scnleimer
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