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Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date -, 19_______ Permit No. _
Application is hereby made for a permit to
—
a story, Type _ Building _ Use Zone
at Occupancy
to be occupied only as Parking Space
in accordance with Plans, Specifications and Plot-plan filed herewith, Fire Sprinkler.
Emer. Elect.
Estimated Value of Improvements, $
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 Address
By Address
RECORD OF INSPECTION
Foundation _ Frame
Stucco Finish
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