52252 (2) 1108 E1mAford
V z:/.S ,;.2 J /Z W/ Lot No. �
Tract No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date / — 1 t , 19 G 7 Permit No. S—z z)i -��✓
Application is hereb made for a permit to
a 2— story, Type Building Use Zone/L!
at it J I'vjrG •JOf•_[ Occupancy
to be occupied only as Parking Space
in accordance with Plans, Specifi #ions and Plot- an filed herewith. Fire Sprinkler
Estimated Value of Improvements, $
Exemption from requirement for State of California for Contractor's License is hereby claimed by undersigned:
as owner ❑ statement filed ❑s �/j{ /�� 5G�
Undersigned attests that his State of California Contractor's License #r /✓ -,
is in full force and effect and properly authorizes this appl icatien.
San Jose City Business License # 1 —/19 ¢�
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 the workmen's compensation laws of California.
Owr��rer�/pT /yf/.vTtRd t`IC. f Address ��)sS � S .r}N•Jdtt
By'La..d „r„4 AddressXd*f dt Rtil+�L
99/5--W01-1-08Z
C 7 PCZ
smi
< 9 ' awed VWVC7-- 4, uo14opuno j
NO11O3dSN1 d0 C21003a