52252 (2) 1153 Stafford qq Q
Tract No.`31 Z G Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date /_ 7 _ , 19 4- 7 Permit No. 5Z-
Application
Z-Application is hereby made for raa�peerrm�iit to
I 7. story, Type JiiI� Build ni gr/sr/v Use Zone,4P9__-_L_
at 11 s 3' .$779FPeWo 17060 SR�NyyJit L. Occupancy
to be occupied only asSir6��( F A+.. �GParking�Space
� p iris nkler
in accordance with Plans, Specifications and Plot-plan filed herewith. Fire S
Estimated Value of Improvements, $ Z!?, UJsl,yJ
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 # /✓✓ •7
is in full force and effect and properly authorizes }his a plication.
San Jose City Business License # 4 zOS �
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 a, to violate the workmen's compensation laws of California.
Owner�_.�pY 'r &ve. =~L' AddresstL7S S'Iyw�, �fss
By-),d � ,a,.. +. —Address rot—WC /!S A-MIVE
99/S-W01-1-08Z
• Q�� n� �
Q } ysiw000n}S
ewes 1 t uoilopuno j
N01103dSNl d0 480038