86065 7479 Bollinger Rd. ,
Tract No.— Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date GI ^ (p 19 —7 'T Permit No.�
Application is heref ade for a permit to A 17 �O
a_�story, Type g 7'7^ Use Zone
a+ 7 y' zQ a'v V Occupancy
to be occupied only as fffja /le A'/d FAnA )?#A .Parking Space
/(oof ,ita .fire Sprinkler
in accordance with Plans, Specifica ' ns and PloT- n I d ewi+ /-c
mer. Elect.
Estimated Value of Improvement
I certify that in the performance of the work for which this permit is issued I shell not employ any person
in anymegper so es to violate the workmen's compensation laws of California.
Ownerm;507 :Lam T2_ Address
By lsc Address
RECORD OF INSPECTION
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7479 Bollinger Rd. B. Schmitz
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