51435 (2)931 Blazingwood
Tract No. Lot No.
CITY OF SAN JOSE I BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT Sy 3 aa—
Date 9 - 27 , ig —4,6 Permit No.
Application is hereby made for a permit to _�..r P�/. 0-14
a 4 story, Type d' g Use Zone R_
at Occupancy
to be occupied only as a.. Parking Space Z -
in accordance with Plansp n1r1S
fica ions and Plot Ian fil he 1 Fire Sprinkler
Estimated Value of Im r /x�•Ezampiion from raquiramenia California for Contractor's License i" s hereby claimed by undersigned:
as owner ❑ statement filed ❑ I
Undersigned attests that his State of California Contractor's License
is in full force and effect and properly authorizes this application.'
San Jose City Business License # Y y/ �� J
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 to violate the workmen's compensation laws of California. yr
Ownee - z /t% et it rn ��g�,4 Address
By, {�� o /% % rr Address �Z�l Ni!Tct,r Z �J
931 Blazingwood Sam Mutakami —
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