540481125 Yorkshire
Tract No.rJ L Lot No. O c
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CITY OF SAN JOSE BUILDING DEPARTMENT
fAPPLICATION FOR BUILDING PERMIT pu-
Date 0' 19 e`4 Permit No. '� 0 4 a
Application is hereby made for a permit to Carve'%em'''u
I % story, Type Building Use Zone
at //2-5 — arf S l / 9z0%4#::7Occupancy
to be occupied only as Parking Space
r
Fire -Sprinkler -
in
in accordance with Plans, Specifications and�Plo+-p1a`n fil�'her� J
Estimated Value of Improvements, $
Exemption from requirement for Siete of Calie fo� tractor's icense is hereby claimed by undersigned:
as owner ❑ statement filed ❑ z / 71 W
Undersigned -attests that his State of California Contractor's License # �3 _ /
is in full force and offecf and properly fufhors�is 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 person
in any manner so as }o violays�the workman's compensation laws of California.
Owr�er 'J' ^^"'� 2`'��- �' Address // 75 .Sl��✓� `�
By 1�� Address at --e!22 !LLI
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