6133 (2) 7465 Rollingdell Dr. �r J`77 5329
Traci No. Lot No. a�L
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT q ��
Date�— 2 7- 77 19� Pe mit No. X33 �JL
Application is hereb ffi�emit o p� �stor , T e i Use Zone (V.2cf✓a� /j� Occupancy_�
to be occupied only as der .1 m ace
in accordance with Plans, Specificatio s and Plot-plan filed herewith. v pnnkler
Emer. Elect.
Estimated Value of Improvements, $,/.5--e 6
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 as to v a#a the workmen's compensation laws of California.
Owner Address '.7
gy `- Address /C
RECORD OF INSPECTION
Foundation Frame
Stucco Finish - '-7
260-601N
Esempfionyfrom requirement for State of.California for Contractors License is hereby claimed by applicant:
as owner �q statement filed ❑
Applicant attests that his State of California Contractor's License #
is in full force and effect and properly authorizes this application.
Sari Jose City Business License #
I, THE APPLICANT OF THIS PERMIT, DO AGREE TO CORRECT THE BUILDING AND
ZONING VIOLATIONS FOR WHICH THIS PERMIT IS ISSUED, WITHIN_ /Q
DAYS. I FURTHER UNDERSTAND THAT IF THE CORRECTIONS ARE NOT MADE
WITHIN THE ALLOTTED TIME, THIS PERMIT WILL BE CONSIDERED VOID AND WILL
BE SUBJECT TO CITATION FOR
�/✓BUILDING
' OR ZONING CODE VIOLATIONS.
SIGNED: f� �
DATED: �7- -7
280-601 N