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62053 (2) 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