94886 (2) 1136 ROLLINGDELL COURT/ MS�
m,O,e,L 4/
Tract No. 5-794 Lot No.1-
CITY OF SAN JOSE BUILDING DEPARTMENT
/ APPLICATION FOR BUILDING PERMIT
Da#e_�! 197 Permit No.'; 5� �L
Application is hereby made for a permit to
e_Z story Type Use Zone
at.1LLN6_t2 - _— Occupancy /
to be occupied only asZ Gam/ .� �arb'ing Space z
in accordance with Plans, Specifications and plan filed `-Fire Sprinkler
P $
® 410 Elmer. Pact.
Estimated Value of Improvements, �I- 2Z 4L4
I certify that in the performance of The work for which this permit is issued I shall nofemploy any penon
in any me sp as to olete the workmen cympensation laws of California.
Ow e l�� Addres✓777 L�D
By Address
RECORD OF INSPEC�1 yV7Y*�'�4eco
Foundation:, f
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 #y 7/ .4 IJ Ste'
is in full force and effect and properly authorizes this appll''�ft'
San Jose City Business License .jp_ �"J�� Q 0 -7 �9
280-601 N