69928 (2) 7530 Bollinger Rd.
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date 197/ Permit No. K; t—
Application is h made for a permit + '''/�,�
a _story, .T pe Use Zone
at Occupancy /
�' Y arking Space 2-
Fire be occupied only as F 92 � Fire Sprinkler
in accordance with Plans, Specifi t nd U � Emer. Elect.
Estimated Value of Improvements, $
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 es to v late the wor rnon's compensation laws of California.
Owne ��D/V ' � ���f7 Address 5'3U 15, Z �lGC2
By Address LC
ORD OF INSPECTION /
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