862067471 Bollinger Rd.
Tract No. v2 14 7 Lot No.4
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date 111i� , 19,/, Permit No.
Application is hereby made f p r/ f o
a story, Type /, ✓Y i Use Zone
at / 7/ //i a Occupancy
to be occupied only as� /l �� / Parking Space
in accordance with Plans, Specificatio ot-plat h eb/ Sprinkler
-
0
Elect.
Estimated Value of Improvements, $ 3Jrca, Oo
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 /n�n f1-6 P_.; v8rWGJZ2 Address %;/ %/ 4 OZ -12
By 69 K- P. pig n/,S Address 47 AV 3ViJl -11i d 2
y�y,G�y��fRECORD OF INSPECTION
Foundation Frame
Frame
Stucco Finish
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