60280LL49 Hollyhead
Tract No. Lot No. '
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT / p
Date 2- 2 , ig 6 9 Permit No. 6 G
Application is hereby made for a permit to, RI/j, p A DD
astory, Type R_ t 6'S Building Use Zone
at /1 c/,9 14 o Le�� 14E p � Occupancy /
to be occupied only as /vv Parking Space
in accordance with Plans, Specific tions and Plot -plan filed herewith, F,ir/e' Sprinkler
Estimated Value of Improvements, $
I certify that in the performance of the work for which this permit is issu I shall not employ any person
in any manner so as to violate the workmen's compensation laws of California.
Owner LC/Z Y S N t T__ U QS T Address /l Y 9 /BOLL �i 6 �h //
gy_
Address—?J—j-
0
ddress�rJ
S°^�^ T �" CO, �R�E�C(iORD OF INSPECTION Qa�d{���
Foundation 3--4'b9 &AA Frame - " t—" �'
Stucco 3 ' �'� G P—k* 1 Finish
r�
1149 Hollyhead Lane `J Robert Smethurst
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 authorizes this application.
San Jose City Business License # !!�
Form 280.1