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Tract No. Lot No. Iµ(• yyC➢7�
CITY OF SAN JOSE BUILDING DEPRRTMENL
APPLICATION FOR BUILDING PERMIT
Date_— I 19 Permit No._4m() (
Application is hereby made for a permit
a—/storm' Type �— _ B 'din -7+' Use Zone
at `77 J S _(��' / �--Occupancy
to be occupied only as_ ``� '� L Parking Space
in accordance with Plans, Specifications and IP �'n filet 4v� Electr
Estimated Value of Improvements, $6Y � •
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 _�__ �_Q/2�7_� Address
y ORD OF INSPECTION _
undation_O _ `` 7S� Frame
Stucco Finish
7555 HOLLANDERRY PLACE VINSON
Exemption from requirement for State of California for Confracfor'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 effect and properly authorizes This app' afion.
San Jose City Business License
Farm 9RO-1 `