93938 1135 HOLLYHEAD LANE
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date , , 197(o Permit No.-
A plication is hereby m de for a permit to ��6�2e t -
a_/ story, y B ' i5 tte G ase Zone '-
at %J -s' Occupancy /
to be occupied only L Parking Space Z
in accordance with Plans, Specific Pi I n it eryth� ire Sprinkler
C2(3 .yJ Emer. Elect.
Estimated Value of Improvements, $ 3aO J �TV
I certify that in the performance of the work for which this permit is issued I shall not employ any person
in any mann so as tc violate t e workmen's compensation laws of California./ p
Owner _ _ Address „�g �7( �/c'(
By_ Address �� �-
ORD OF INSPECTION
undation JJ /°��� Frame�7q¢ �
Stucco7�yP�i4 M{'��G —� Finish /c
1135 HOLLYHEAD LANE R. WALLACE 260-601N
Exemption from requirement for State of California for Contrac/or'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 application.
Sen Jose City Business License # �Ys�lsZ--t< 7
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