81301 5941 Bollinger RoAd
Tract No. 0 0 Lot 'No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date yW3-,tea, 19 7y Permit No. ?_'�r_2 /
Application is hereby made for a permit to a LJ. P e o L
a Istory, Type lS,I. Building IP es Use Zone It
at J"9y/ �e/L.iatr_��• Occupancy___
to be occupied only as Sr_t'yt
join../ Parking Space
Fire Sprinkler
in accordance with Plans, Specifications and Plot-plan filed herewith. Emer. Elect.
Estimated Value of Improvements, $ � o o
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 workman's compensation laws of California,
Owner Address
_ Address T �'
By C t< i RECORD OF
,eI,N�S�PEC I N
Foundation
Stucco Finish (*=7—
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