51757 (2) 1105 Elmsford ���� 3" l
Tract No.s]_[_0a'Lot No.-Rie—
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FORBUILDING PERMIT .-
Date_/O . J � . 19 `` • Permit No. "17 5 7
� Application is-hereby..made for a permit to w.VJTibNGT?
a_/—_story, Type Building FDa3p w'yyam�' Use Zon I`
fit& _ bccupancy I' r
to be occupied only as" Parking Space i�
T. an file�de ' k,
ler
in accordance with Plans, Specifications�an
Estimated Value of Improvements, $
.
Exemption from requirement for $fa}a of California for Contractor's Licanse is hereby claimed by undersig nad:
as owner ❑ statemenf filed ❑
Undersigned af}ezts that his. Stafe'of California Contractor's License #
is in full force and effect and properly-a/a�uthorizes�this application.
San Jose City Business License # 7' la rfe
I.certify that in the performance of fhe work for which this permit is issued I shall not employ any person
in any man a o viole}e tha orkman's compensation laws of California
Own r_/1 4�JriQ �S�• AIQ�ddress //�J'.j/Ywf�
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