70463-V (2) 8085-8� Park Villa Circle
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CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT -70917'
Date
19111 Permit No. 7U 9(13 -
Application is hereby made for a permit }o G,0 W
i ?do Al-
a�N story, Type uilding _ Use Zone
a+ �y�7��0(� s9 Q c� /LGA /�CC� Occupancy A
to be occupied onlyas K ,�`��j�'��`'Fj-PF'einn�$$gpSpace
er
in accordance with Plans, SPSP c� and Plotplanlfiledd her�evJi+h� C/
'§ " mer.,OElec+.
Estimated Value of Improvements, 46-121-3-/0
1 certify that in the performance of the work for which this permit is issued I shall not employ any person
in any me ar so es to volafe th workm n's compensation laws of California.
Own (P`, �/ ES ✓, /9F�-kW4�*ddresz /D30�illas/s ///�IJLD/��
Address
RECORD OF INSPECTION �l
Foundation/-
Stucco Finish �-
00?A
Exemption from requirement for State of California for Contractor's License is hereby claimed by applicant:
as owner ❑ statement filed ❑
Applicant attests that his State of California Contractor's License # /Z;��/
is in full force and effect and properly authorizes this application.
San Jose City Business Licensee ##
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