51757 1109 Stafford
Tract No.NAIC Lot No.-9 /
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT _ _
Date�a.��' 19 `` • Permif'No. S 7 � 7
Application is hereb made r a permit to ldw/JAPOWD T
a-2_story, Type_ Buina/10 Use Zone
at 0 or! ,f, Occupancy f
to be occupied only Parking Space ?/
in accordance with Plans, $ ecifications and
herew
Plo}¢"len filed ith, Fire Sprinkler
Estimated Value of Improvements, $ �7j0oo�er�Sd�V�
Exemption from requirement for State of California for Contractor's License is hereby claimed by undersigned:
as owner ❑ statement filed ❑
Undersigned attests that his State of California Contractor's License # .✓-'
is in full force and effect and properly
authorizes }hiQs aep plication.
San Jose City Business License # ?'�Os • 8 '
I certify that in the performance of the work for which this permit is issued I shall not employ any parson
in any man ss�es t violate }he orkmen's compensa}ion laws'ooff'Callifornia.
Owner `s/' �VeAddress
BY��ti�%z 7�l ,�1� Address
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99/5—W01—I-OBZ w�oj
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