89337 (2) 1191 Crestline Drive
Tract No. Lot No. 90
CITY OF SAN JOSE BUILDING DEPARTMENT
1APPLICATION FOR BUILDING PERMIT �1a9
Date 'rF 19 `fes` Permit No. ?,q-1-37_._(
Applicdfion is hereby me r a r
a story, Type Use Zoney
at Occupancy
to be occupied only as mg
Space
lo+ eSprinkler
in accordance with PlanSpecifca+i a fd
Emer. Elect.
Estimated Value of Improvements, $ •4oc�D—.
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 th workman's compensation laws of California.
Owner_ Address
By Address
v q `
RECORD OF INSPECTION
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