51757 1137 Stafford '' ' ' y
Tract NJIZ Lot No. /
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION Fp BUILDING PERMIT
Date 16-Y 19 P� PermiF No. 6( 7 5-7
Application is hereb made for a permit to GbIVS�VGr a— ,
a_jL story, Type_"' Building Use Zone
at //.� 7 a19/'�/ta.0 V, rr ��fO Occupancy
to be occupied only asci✓ __ G,f. Parking Space
in accordance with Plans, Specifications and Plot-plan7filed herewith. Fire Spri�nkller
Estimated Value of Improvements, $ Z4j 000. a& ��%
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 thesis application.
San Jose City Business License # 4_/4 -
I certify that in the performance of the work for which this permit is issued I shall not employ any person
in any manner
so as to folate thgg workmen's compensation laws of California:
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