5005 7573 Waterford Dr.
Tract No. Lot No.
CITY OF SAN JOSE BUILDING 0,EPARTMENT
APPLICATION FOR BUILDING PERMIT ''�Z>
Date -125 . 119 77 Per t No.
Application is hereby ma for a permit to �/0, X/L yL
a story,Type — Building /ffse Zone A /
at Occupancy
to be occupied only as /1� Sq.feet
in accordance with Plans,S ecifications d Plot-plan filed herewith. Parking Space
Estimated Value of Improvements, $ Fire Sprinkler
G��7"(J��/I/¢fit.
I certify that in the performance of the work for which t1 is permit is i ed 1 shall odt employ any person
in any mirmter so as to violate the workmen's compensation laws of California.,, e
Ower.• - 'Address Z�73 U.9`�l'G2Fe2A
By, vt^^`,y-4AQe.w Lt'v.-I Vv Address #2- QAUnR0t1 �—Ppk c, V.
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This permit shall expire and become null and void if the work authorized by it is not commenced within
120 days from the date issued or if the work is suspended or abandoned for a period of 120 days after
commencement.
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• 1.LOCATION 2. DATE RCD. 3.TIME RCD.
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