94904 1135 Hollyhead Lane C R:Jr_c.a -010""9
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
PLICATION FOR BUILDING PERMIT Oy
Date , 19_`�__ Pe it No.
Applica ' is by ade r a permit to
a_�sfory, Typpe g�J ng !O Use Zone
at " b f�–� -- " V Occupancy
to be occupied only es_{._[� F �J/ Parkin S ace
in accordance with Plans, Specifications and Plot-fled r ith.
l� Emer. Elect.
Estimated Value of Improvements, f � 02�-�—_—.
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 �S 106t Address 115' YZJlew
gys4 Address
RECORD OF INSPECTION
Foundation Frame
Stucco Finish
i 260-601N
11 zc U. l 1 srhna i Tana hdir, r:vAWalIace
Exemption-from requirement for State of California for Contractor'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 authorises this application.
San Jose City flusiness License #
280-601 N