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1148 Stafford /
Tract No.GTI14 Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION f5R BUILDING PERMIT
Date S — 19 Permit No. �E 3 2V
Application is hereby made for a permit 3t�Co.✓.e7m vvT
a story, Type z ✓Building Use Zone �•�
a+ �/yfl ST�"f lariMl� Ar. .S• f• Occupancy
to be occupied only as �[j//] Parkg•Space 2
in accordance with Plans, Specifications andel Plot-plan filed herewith. Fire-Sprinkler
Estimated Value of Improvements, $ C214 00 N
Exemption from requirement for State of California for Contractor's License is hereby claimed by undersigned:
as owner ❑ statement filed ❑
Undersigned attests that his State of California Contractor's License #
is in full force and effect and properly ju� � plication.
San Jose City Business License # QV 0
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 as to viol to the workman's on, ensation laws�i California.
Owner ' Address i�rS h+w y eJ
Byer �® d/4 Vp Addresscl�449
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