948861112 ROLLTNGDELL COURT 010II00eA e41416
Tract No. _! S Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date _/ �'d 1974 Permit No.
Application is hereby mase for a permit to
:t
_� sforX, Type $� _ 'Idjn Use Zone
at -Z _ Occupancy z
to be occupied only as L , W, Parking Space z.
in accordance with Plans, Specificafi ,pnd Plot -plan filed herewith.Fire Sprinkler
Estimated Value of Im rovemen4 ,
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 Sbq--workmen's corppensefion laws of Califoppia. a s C7
By /�( �/�d s�� Address
RECORD OF INSEE
Frame
Stucco /0'':�-Z I ✓ Finish
260-601N
p1li17L �72t �sY���9 )fAM449.—
Exemption from requirement for State of California for Contractor's License is hereby claimed by applicant:
as owner ❑ statement filed ❑ /�
Applicant atfests that his State of California Contractor's License # 7 7 3 "7a,
is in full force and effect and properly authorizes this application.
San Jose City Business License #
F110411, I/ r -Mle
P C40,111le— 4, 40
280-601 N