96264 (2) 75'60~''-BOLLINGER ROAD 4 pub
Tract No. 573'Q_ Lot No.�
CITY OF SAN JOSE BUILDING DEP IiT
QAPPLICATION FOR �BUILDING PERMIT
Date - �= , 19_L.(_--- Permit No.
Application is hereby made for a permit to ?LD
a_�_story, Type uJd'g Use Zone QJ l? L
at � _ Occupancy _Z
to bei occupied only as .Fa� Perking Space__
in accordance with Plans, Speci i tiogs and Plot-pI filed herewith, Fire Sprinkler
R
'Estimated Value of Improve s,
me . Elect.
I certify that in the performance of the work for which this permit is is ed a I not employ any person
lin any manner as to violate the workmen's compensation laws of California.
Owner T / S_ Address5/0 X AgArt*t.D41_S4-�
I;y Address /I
�ECORD OF INSPECTION,�(//,/ /
Foundation Frame a
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