77347 (2) 1191 Crestline Drive
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date l ' 197-5 Permit No.?2�1yZ
Application is hereb made for a permit to/�-YW
a 4 _s+ory, Type ildirt�-/_ —Use Zone lelPar
of / �� I/V Occupancy
to be occupied only as / -/Gx/Y Parking Space Z
in accordance with Plans, Specifics ns and Plot-plan filed rewith. Fire Sprinkler
. Elect.
Estimated Value of Improvement ,
I certify that in the perform ce of a for whi h i p r tis iss I s II not employ any parson
in any nner so as o vi he workmen's compensation laws of California, (( ''
Owner — Address Ilgl CPES e Q
By
&--r<I 1/y5 Address
RECORD OF INSPE ION p,
Foundatio
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Stucco Finish
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1191 Crestline Drive 9 Japes. 0. Atkins, III
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