6917 (2) 882 Kim St.
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date //— 3 19 77 Permit No.
Application is hereby made for a permit to z9,�2&✓(CAr ri'I oar+so�
a story,Type �—,1VXP� Building Use-Zone
at $ / _ ^� ,/� �y�7i Occupancy
to be occupied only as z r�J "" C`^,,.SQ. feet
in accordance with Plans,Specificatio nd Plot plan filed herewith. Parking Space
Estimated Value of Improvements, ! o • Fire.Sprinkler
/nn � erXect.�(
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 workman's compensation laws of California.
Owner /�/�/�7�/1 la-//—?e Address /) ;SA A-//Y S1
By �q n� Address J�/7nP
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. � -/,�. -
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