72424 7458 Bollinger Rd.
Tract No. Lot No.
CITY OF SAN JOSE BUILDING DEPARTMENT
LAAPPLICA/TION FOR BUILDING PERMIT GX
Date "/— �--Z b , 19 �2 P rmit No.
Application is hereby m eI f r
a-0)—story, Ty p 1 Use Zone
at — Occupancy,
parking Space
to be occupied only as IfffUUUU
in accordance with Plans, Specifications an Plof-plan filed herewit - Fire Sprinkler.)
Emer. Elect.
Estimated Value of Improvements, $ U O 0
I certify that in the performance of the work or 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.
Owner_ Address
Address 7 j /z I�f� �
RECORD OF INSPECTIO 7r�-41-7Z
Foundation Fra� Z`
Stucco Finish 'g—.22-2;7
7458 BollingerRd. Martin (� /�
Exemption from requirement for State of California for Contractor's License is hereby claimed by applicant:
as owner X . statement filed ❑
Applicant attests that his State of California Contractor's License #
is in full force and effect and properly authorises this'application.
San Jose City Business License # '
3/S-Tt4- /a& INJP • bYvac !teIxI6-r ✓o2a�ni�
/�.'+VW /.�pNtl Qd/L latOdrt�C�6'6 r� h�ELY741lJt'/
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Form 280-1