41056295 Shadygrove' Ct.Y
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
DateI-19-7�_l Permit No.
Application is is hereor a permit fo I
a7occupied
1sfory, Typ B 'I Use Zone
ofOccupancy
toonly as .25,Parking Space
Fire Sprinkler
in th Plans, Speci icafions and Plof-pla, filed herewith. lect.Esof Improvements, $
1 certify that in the performance of the work for which this permit is issued I A employ any person
in any manner so as to violate the workmen's compensation laws of California
Owner Address � c
By S' Address �_ ✓ne-
RECORD OF INSPECTION
Foundation
Frame
Finish
260-601N
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8. APPROVED ( 9. R MARKS:
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