95280 1183 STAFFORD DRIVE
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT l
Date g,� 19 < Pis rmiteNp J�
Applicetio_-_ mad r a permit to CCaeV
prinkler
a�story, Type • Building s Use Zone
at 1 (.d l/ q;/1'/0 Occupancy S
to 6e occupied only as � (//fxLa? erking $pece�
in accordance with Plans, 5peeificefions and Plot-plan fi her t F�Eme. Elect.
Estimated Value of Improvements, $
I certify that in the performance of the we for which his permit is issued I shall not employ any person
in any manner so as to violate the workman's compensation laws of California.
Owner Address /J
B _ G' < d� Address /D0c'dV
RECORD OF INSPEC�10�I
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Foundation Frame4
�n G(SL< � �1Finish '� -7ry 5
Stucco - -
�~ 260-601N
1183 5TAFFORD DRIVE
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