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Tract No:'r� 4 Lot NO.
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CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date D�03Fi�� 7 19 -71 Permit No. ?0463- Y
Application is hereby made for a permit to 14e 1" I�
a1 601 story, Type Nj� Buuildiing Use Zone R-/B"/
at ��/S3 '0��( �LG9 _ G/L _ Occupancy z
_ _
_ rking Space_
to be occupied only �/.
in accordance with Plans, Spe i i a ions and Plof-pla fi16 ere it Fire Sprinkler
/b- 9/-i4-3
Estimated Value of Improvements, $ 30���`� f[l--� 3%03`
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 asto iolafa he ftn, pensaCon laws of Celitess la-
ByG� '/ L� — r . ddress
RECORD OF INSPECTION'
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