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54067 1215 Stafford Tract No. Lot No. CITY OF SAN JOSE BUILDING DEPARTMENT / 7 APPLICATION FOR BUILDING PERMIT �L. Date —16 , 19 6 7 Permit No. .`-6 %6 J Application is hereby made for a permit to a slog, Building Use Zone�� a+� l_ S F_F/JR ��, /UX/6 7- O ccupancy 4— to be occupied only as � v Par ',;j pace Z ,71/V,�/. p .� in accordance with Plans, Specifications and Plot-p�8f led herewith. re�pnnkler Estimated Value of Improvements, $ (j�© Exemptionnffroom requirement for State of California for Contractor's License is hereby claimed by undersigned: as owner Qg stafoment filed ❑ Undersign attests that his State of California Contractor's License # is in full force and effect and properly authorizes this application. San Jose City Business License # I certify that in the porfor encs o e ork for which this permit is issued I shall not employ any person in any manso as to viola the w rL a s compensation laws of California T Owner"Ay�t^^^ o a� Address f�lr o - � I)r• Crptw By Address 1215 Stafford Kenneth Peck 99/5—W01—I'On w,Oj Cyf Ul j coon+S ewes � . uoppung NO11OUSNI dO 48OOM V