53986-F (2) 1658 Jamestown pool
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date ��//�C� 3// , 19 K 7 Permit No. 5386' r'
Application is hereby made for a ermit to /c-/P or f�
a_story, Type ' uil Use Zone
at 7Vl�J� '� ccupancy_��
to be occupied only as o /(/ tf f rk ng Space
in accordance with Plans. Specifications and Plot-plan filed herewith. Fire Sprinkler
Estimated Value of Improvements, $ kZ 2 U G
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 # /? Z✓ ?7
is in full force and effect and properly authorizes this application.
San Jose City Business License # �G — zyQ
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 violafe the workman's compensation laws of California.
Owner �a'U`'S Address_/�i,5�.� ,�11��7D/�
By �.dd i ft/ �4w-Address 1..323 7
1658 Jamestan D. Jones (�trE
-7 RECORD OF INSPECTION
Foundation / � /,V.4 it wr / Frame
Stucco Finish
Form 2801—IOM—5/66