514027439 Stanford
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
,11lPPLICATION FOR BUILDING PERMIT
Date , 19 46 Permit No..-�—/ <16 2
Application is herAy made for a permit to
a_/ --story, Type R
Use Zone
at 75'9 SzANFv/ZU, Occupancy
to be occupied only as / F 4 M, tLTl e
in accordance with Plans, Specifications and Plot-pla file erewith. er
Estimated Value of Improvements, $,T C/o,
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 this application.
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 parson
in any manner so as to violate the workmen's compensation laws of California.
Owner Lo .F le — MATKE4ui4Address 7/ 3 f jt:: �
Byf� iA/l�%%r t��ll� Address
7439 Stanford Gerald Lee Mathews,��
09 0
:10 ON033V
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