94233 F (2) 1177 CRESTLINE DRIVE
Tract No. :�Wg Lot' No. •v
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT p .�
Date z 7 . 19 -7�, Permit No._�Va—
Application ishereby m f r �if
:a story, TypevlB d Use Zone
f-//7'Z (-'P- -n 'nt -L)k, Occupancy
to be occupied only as_f1Ba.u�h'_� A �1//v X'Fire S Space
in accordance with Plans, Specifications d of-pan fr ed herewith/ Fire Sprinkler
Emer. Elect.
Estimated Value of Improvements, t. 7�1Q
oy
I certify that in the performance of the work for which this permit is issued I shell not employ any person
in any manner
, "so as to violate the workmen's compensation laws of Calif ornia.
Owner�rrrG' Address //7,� C PQ iqQ t)'?'
By �� :_ . ��ov G> Address NZ-, 7
�7 RECO D OF INSPECTION
Foundation/ e/�d Frame
Stucco - Finish
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