15643 (2) 7967 'Folkestone Dr. / /
Tract No. _.�� (� Lot No. �7
CITY OF SAN JOSE BUILDING DEPARTMENT
.y APPLICATIONFOR BUILDING PERMIT ✓F' 7 0
Date 4 '—��0 , 19 Permit No.
Application is hereby made for permit to
a _�story,Type Builds g !pro Use Zone "�
at be occupied ti?—,y� Dh• Occupancy
–15
to be occupied only as Sq.feet �/O
in accordance with Plans peclfications and PPllot-plan filed herewith. Parking Space
Estimated Value of Improvements, $ .��/�� Fire Sprinkler
Emer. Elect.
I certify that in the performance of the work for which this permit is issued I shall not employ anyperson
in any manner so as to violate the workmen's compensation laws ofOCalliifornia.
Owner // ��!! Address 7 /6 7
ey koUr& Zr ✓N�� 2✓ l6NT Address4924 AZ
This permit shall expire and become null and void if the work authorized by it is not commenced within
120 days from the date issued or if the work is suspended or abandoned for a period of 120 days after
commencement. �/y�j
FINAL INSPECTION �t-e�/ 200.601 N ,
Exemption from requirement for State of Cal ifo.,rnia for C'ontractor's License is hereby claimed by applicant:
as owner ❑ statement filed I,J/ /
Applicant attests that his State of California Contractor's License No. 6 (
is in full force and effect and properly authoriz this application.
San Jose City Business License No. O 07 Z
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