61526 1352 Stelling
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT 2G
Date S'21 19-6�--, ,��Permit o.
Application is herebymade for a permitpermit to �N-r ✓ 4 Ag� 'y/•
a�_story, Type uilding Use Zone ' 2"�
at Occupancy /
to be occupied only as //f��T�/ Parking Space Z
Fire Sprinkler
in accordance with Plans, Specific ions and Plot-plan filed herewi}h.
Estimated Value of Improvements, $
I certify that in the performance of the work for which this permit is issued I shalt not employ any person
in any manner so as to violate the work'men's compensation laws of California.
Owner v/6 i Tot/, Address --
ByZ21 r_(!c: Address --..
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RECORD OF INSPECTION ^ o
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