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Tract No. �l/6 Lot No. G
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION //FOR BUILDING PERMIT
Date `tea .3 i9w„ Permit No. S3 S� g
Application is here made for a permit to �T
a stor Type Building Use ZoneL'4L�
�i
/Occupancy�—
to be occupied only as epnogqE7 Parking Space a
in accordance with Plans, Specifics ions annd`Plof-plan filed herewith. Fire er
Estimated Value of Improvements, $ 00
Exemption from requirement for State of California for Contractor's License is hereby claimed by undersigned:
as owner ❑ statement filed ❑ e
Undersigned attests that his State of California Contractor's License #/3 —/ -
is in full force and effect and properly(authorizes this ap lication.
San Jose City Business License
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 violate o w}o kmen's'com nsation laws of California.
Owner (CAO” ciclress L/ 7`r
Y
B • VP' Address
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