81571 (2) 899 'September Drive
Tract No.'4/3 Lot No./
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT '
Dafa l 19-�—� Permit No
Application is hereby made for a p 't t
a—f1�story, Type_��1 u7 isgUse Zone —fE-
a# Occupancy
to be occupied only as P ring ce
in accordance with Plans, Specifications and Plo#-plawfil ere if • Emer. ecL4 #.
Estimated Value of Improvements, $ q0 C) U
I certify that in the performance of the work for which this permit is issued I shall not employ any parson
in any manner so as to violate the workman's compensation laws of California.
Owner Address g
gy `rp_r ZC� 1y0 Address
REC RD OF INSPECTION
Foundation 20WFrame a
Stucco Finish 2 3- ;7,*1-
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