1782 (2) 852 .B`ETLTN' AV'ENTT� "
Tract No. Lot No.
CITY OF SAN JOSEBUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT ' Z'
Date 3 --/,Il 19 7'T Permit No. 7$"3—
Application,is hereby made for a permit #o
a—1story, Type Buildi Use Zeno
at ` � �—Occupancy
to be occupied only as .�r.. Parking Space
�� Fire Sprinkler
in accordance with Plans, Specifications end%Plot-plan filed herewith.
(J� tw_ c (/Emer. Elect.
Estimated Value of Improvemen#s, =�YQ9 /✓ �f/C.
1 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 f " I tts the workmen's compensation laws of California.
Owimb L �/•r ���� AddressVS2 EIZ/ t) StirV J
By fi j,a c) Tt'KM lZE4 k Address IW70 t MfQ1/�
RECORD OF INSPECTION
Foundation Frame ✓�—� `l ,7�L�^^Z
Stucco Finish
260-6011;
852 BETLIN AVENUE NORM PARRISH
Exemption from requirement for State of California for Contractor's License is hereby claimed by applicant:
as owner ❑ statement filed ❑
Applicant attests that his State of California Contractor's License. # T 7t 7
is in full force and effect and properly authorizes this application. -
San Jose City Business License # f 7 — n ' -r— 35
t
280-601 N
1. LOCATION _ 2. DATE RCD: 3.TIME RCD.
.• 4.READY ' AM ( 1 ANYTIME ( 1 5.TYPE OF 6.A REA 7. INSPT.MADE �3-
PM 1 1 SPECIFY INSPECT. TIME Z
DATE _
' . 8.APPROVED ' ( I 9.REMARKS:
DISAPPROVED ( 1 Ie
cn
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INSPECTORJSOC.��+ _
280-671
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