61904F (2) 1121 Stelling Rd 4-tuA9 7 - z- y -69 °
Tract No., �, Z Lot No. Z
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT Q _464 G
Date - 1' / 19 CO 9 Permit No. (/
Application is hereby made for a,Permit to /
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a story, Type o / uilding
Use Zone
at �/ _ ��Occupancy J_
to be occupied only as Parking Space
i of
in accordance with Plans, Specifications and Plot-p f Cd I mkler
Estimated Value of Improvements, $ c� y
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 violate the workmen's compensation laws of California./
Owner ?-� �Addrers
By� / Address 17, s'RECORD OF OF INSPECTION
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