70463-V (2) 8093-9� Park Villa Circle 6
Q 1 Tract No.-5eCIO Let
CITY OF SAN JOSE BUILDING DEPARTMENT
nn APPLICATION FOR BUILDING PERMIT ?01927"
Date/!��(� )�E�/ 19--7/—Permit No. 7 Uq"L3
Application is hereby madb for a per 't +o
a �WO story,.T .pe 'Building Use Zone
at (J S 3 U/LL/3 �j�L7 Lam" Occupancy
to be occupied only as ' ,q. y,�.
Parking Space
ler-
in accordance with Plans, Spe ifUc (ions a I le'("" �heriif
fj
ell
t�r. Elect
E er. Elect.
Estimated Value of Improvements, $ �, . -7/--3-/r
I certify that in the performance of the work for which this permit is issued I shall not employ any person
in eny m� so as to violafe• a workmen's com��p//n�,s�alt,igqon laws of Califorf''a.
Own [L° 5 a PLpAtldress /83d 6/1 A 7E'4-A
gy ,GtL Address i
/? RECORD OF INSPECTION
Founda+ion /— 7— 7f Frame
Stucco Finish 7 ZJ , 7 L —�'L—
C otM,�, A45-13
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 #
is in full force and effect and properly authorizes this appli_ation. "
San Jose City Business License #
�D 7
13
Form 280-1