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94886 (2) 1104 ROLLINGDELL COURT Mmaa�L�. 4194 11 Tract No.J76.S Lot No.� CITY OF SAN JOSE BUILDING DEPARTMENT APPLICATION FOR T.G R BUILDING PERMIT Date—�� 197!? Permit No.CQ��G A plication is here m e for mi+ o a_r story, Type _ . 'd' Use Zone Occupancy Z to be occupied only as — 9 c in accordance with Plans, Specifications an filed r i . r er. P f- ecf. Estimated Value of Improvements, _ "u0, O Q Q Z09je om I certify that in the performance of the work for which this permit is issued I shell not employ any person in any manner so as to violafe the workmen's compensation laws of California. (� O r1 Q e — _ _ Address/ By, 4: -L Address �RECORD OF I jPW7& Founda+ion?/N% 1111eG Stucco — Finish 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 #_c2 /7 Z3113 — is in full force and effect and properly authorizes t is--p`plication. —7 San Jose City Business License #_ _Q© G� ?I- 280-601 N