51830 7646 Squirewood
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date // — /�l , 19 �% � •� •A �Permit No.' _� �J
Application is hereby made for a permit to e9".l A�,L
astory, Type' l/ /-00 Buildin Use Zone
at +CXo ccupancy—
to be occupied only as /bx 22ark ng Space 2�
/ 'i'Al pnnkler
in accordance with Plans cifications and Plot-pI ere
Estimated Value of Improvements, $ 3K2 e
Exemption from requirement for State of California for Contractor's License is hereby claimed by undersigned:
as owner ❑ statement filed ❑ �Z
Undersigned attests that his State of California Contractor's License # o
is in full force and effect and properlyGy,�/�horizes Phis app afion.
San Jose City Business
I certify that in the performance of the work for which this permit is issued I shall not employ any person
in any mrr so s to �iolafe the workmen's compensation laws of California.
Owner P Address76 Y�
By h Addres�,V y/ 7:-22
7646 Squirewood ? en �L
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