94886 1121 ROLL2NGDELL COURT / AfOA7t<L
Tract No.17 749 tJ Lof NO.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FO BUILDING PERMIT -
Dafe_7 XV 19 7 Permit No. /
Application is her ad fora er�rpl}/-,to
stor Type _ _/_/ g —use Zone
Occupancy
to be occupied only es�' rking Space Z—
in accordance with Plans, Specifications and Plot-plan=edherew!!+ �ire Sprinkler
-
in
Estimated Value of Improvements, ;g�Vr._ 0 d
I certify that in the performance of the work for which this permit is issued I sh511 n .t employ any person
in any man so ay,to ate t orkmen's compensation laws of California. d}
ow l — — Addres'/777e=�� a4
By_ Address
]� /o 0 CORD OF INSPECT ONS` 0 ///76
Founda#iou" '� Frame 1I 6
S#uct Finish 't ---
260-601N
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 # a • 7 U
is in full force and effect and properly authorises this application.
San Jose City Business License # 4,11OQ
280-601 N