183V (2) '5825`Bollinger Road 'M
Tract No.— Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
v�/7/�/ APPLICATION FOR BUILDING PERMIT
Date—/ , ;24/ , 19-7-62- - Permit No.
Application is herebymade for a permit to
a—L story, Type t)G Z Building_ Use Zone R
at �Q. Rn/ /r r]G Pi l Occupancy CI
to be occupied only as�S '(=) Parking Space
�— Fire Sprinkler
in accordance with Plans, Specifications and Plot-pla fled herewith.
Emer. Elect.
Estimated Value of Improvements, $ (po j 00'6
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 vj lata the work en's compo nsation laws of California. /
Owner /1 / C dZv'Address +?5������
gy_ Address le�5�' h 7�•
$396 R CORD OF INSPECTION
Foundation �� Frame 6 - / (9
n
Stucco Finish 7 77
260-6>31N
5825 Bollinger Road
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 #
is in full force and affect and properly authorizes this application.
San Jose City Business License #
280-601 N
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