61368 6191 Bollinger
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
,/, APPLICATION FOR BUILDING PERMIT
Date J/�y 12 , 19_,'.' Permit No. J� }Z7 6y
Application is hereby made for a permit to -cxsa .iejr.
a story, Type _ Building sse—. Use one
o / ,ems • Occupancy
to be occupied only as GGcu_rrParking Space
in accordance with Plans, Specifications and Plot-plan filed herewith. Fire Sprinkler
Estimated Value of Improvements, $_���/Oy
I certify that in the performance of the wor(for which this permit is issued I shall not employ any person
in any manner so as to violate the workmen's compensation laws of California.
own iLrTto _ =s$r'.s'yTcl�/cyC✓Address 6/?/
Address Tyu Aoxyo l GT 5 f exc
(/� RECORD OF INSPECTION
Foundation Frame
Stucco Finish•
F,191 Rnllinnar
United Presbyterian a E
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