16781 (2) 939 N roa
TracttBubb
No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
P.C.Date APPLICATION FOR BUILDING PERMIT g .�
Date � = / 4' ,197;2 Permit No. &ZZ -/
Application is hereby made for a permit to UA/J 0712 rl GT Scwi tl4iitZ_FtP)L
a story,Type Building Use Zone
at
C1,6 �— Occupancy
to be occupied only as VT Poo ( Sq.feet
In accordance with Plans,Specifications and Plot-plan filed herewith. Parking Space
Estimated Value of Improvements,$ O Fire Sprinkler
Emer.Elect.
1 certify thatI the performance of the work for which this permit is issued shall not employ any person
Ow .I Address �3� ,
By Address 7Y. "Ap
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.
FINAL INSPECTION 280-6.018/78
Exemption from requirement for State of California for Contractor's.
License Is herjoy 4laimed by applicant:
as owner statement filed❑
MPI is that his State of California Comractor's License No.
Is in full force and effect and properly authorizes this application.
San Jose City Business License No.
J