51843 (2) 1148 Scotland
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FPPj, BUILDING PERMIT
Date 19"_Permit No.
Application is hereby made for a permit to '[ !7
a�story, Type E&5 . c�Building Use Zone �-
at l/ C_r� l�gVOccupancy f
to be occupied only as /_ v1, /t/ a ing Space
in accordance with Plans, Specifictlons and lot-plat 'e rewithFirje Sprinkler
Estimated Value-of ImprovQpents, $ d /+// v��
Exemption from req uiremenfJ�for State of California for Con/tractor's License is hereby clamed bundersigned:
as owner ❑ statement filed sa"❑
Undersigned attes+s that his State of California/ Contr`acio/rr License #/�•/ ,/ / '�
is in full force and effect and properly authorizes this application.
San Jose City Business License #
1 certify that in the performance ofT+h¢.work for which this parmii•is issued.) shall not employ any person
in any manner so as to violate the%work on's com pensa+ion laws of California. .
Owner u 11 Address �Q
gy f ''`~9e. Address
31148 Scotland -,A. Aquino
99/5—ml—108Z w,oj
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