53549 (2) 7967 Folkstone 3�•f3
Tract No. '3/Z` Lot No. 6 3
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT p
Date S a3 — , 1962 Permit No. S3 S1 /
Application is hereb made for a permit to Gb 7W vCT
a:!k
story, TypeuUse ZoneaFUI TO S 1 Occupancy
toccupied only as /V���rking Spaceincordance with Plans, Specifi tions and Plot-plan 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 ❑
Undersigned attests that his State of California Contractor's License #r✓ _/ a7
is in full force and effect and properly authorizes th" application.
San Jose City Business License # 7 —fo'yo
I certify that in the performance of the work for which this permit is issued I shall not employ any person
in any maa er so as to vi a the workmen's Npensation laws of California.
O r /� • v^"' �l7 1`r'
Address y
By vAddress ,,Qe2y e
RECORD OF INSPECTION "
Foundation_. S 1.6 7 Luh C,,CFr�aye�_
Stucco inh ish
Form 2801—IOM—5/66