53892 F (2) 1450 Jamestown
Tract No. 370 / Lot No. -s-
CITY
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILD G PERMIT
Date ,(L/lJE r,2 3 , 19 (07-
967 P mif No.
Application is 'hereb mad or a permit to
a `story, Type B 'Id' Use Zone 2V
of _/0--1 ,V V Occupancy
to be occupied only -4/&Het as ✓ ,/� Parking Space
in accordance with Plans, pecifica d Ith. Fire Sprinkler
Estimated Value of Improvements, $ /✓T O O `—`-
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 P P�3
is in full force and effect and properly authorizes this application.
San Jose City Business License # �/— /1 O 2 L ,
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 ARy -,r- /NEi2 Address /'> d
By Al 7-/A/EKE POOL s Address JS,F Z&7 1°17,17,66 e,E-104
1450 Jamestown Gary Turner
RECORD OF INSPECTION
Foundation 7• /9. 6 )1ka Frame
S+ueeo Finish
I
Form 480-1—IOM—5/66