62005-F 1010 Westlyn Way
Tract No. Lot No.
CITY OF SAN JOSE BUILDING' DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date7 Permit No. � _
Applica+ion is hereby made fora permit to BGO
a �- story, Type N Building Use Zone �3
at I (�l u W 3%!j Occupancy 14
to be occupied only as / Parking Space_ 9
/ Fice.Sprinkleer_ _
in accordance with Plans, Specifications and Plot-plan filed her to
Value of Improvemen+s, 3 2 040
I certify that in the performance of thew work fororfor which is issued I shall not employ any person
in any manner so as to violate the workmen's compensation law,
�of Calif nia.
O ner �`�• -' X30^� /�G— Address ddb/-S1eUPNs Cele jALLJ ALL s3
By � Address --
p RECORD OF INSPECTION
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