62053 1575 Jamestown
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT z
Date—zz_/ , 19 6 7—Permit No. 6 Z-C' 5-
Application is hereby made for a permit to_4012 _T
a ,27 —story, Type !/ ^�— Zd' Use Zone
S— y)p/Srvrf� ``
at •c Z, Occupancy
to be occupied only as __7�. / 3=°X C Parking Space
in accordance with Plans, $p c s / a with. Fire Sprinkler
Estimated Value of Improvements, $ ` 0 o�
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 —
gyE� Address
RECORD OF INSPECTION
Foundation_' 31, �
` p� g
Stucco �Inlsh 6Q J CJ /
1 57S Jmm�c:t-nsun Lee
Exemption from requirement for State of California for Contractor's License is hereby claimed by applicant:
as owner ❑ statement filed ❑
Applicant attests that his State of California Contractor's License # 2
is in full force and effect and properly authorizes this application. AA _
San Jose City Business License # lJ Z
Form 280-1