96264 (2) BOLLINGER ROAD SIVE
Tract No. SIM Lot No.�(,;
CITY OF SAN JOSE BUILDING DEPART NT
G APPLICATION FOR BUILDING PERMIT
Date yR , 19 Uo Permit No.
Application is hereby made for a permit t81.D
a story, Type-79—AS S Building Use Zone QI.(3G--
at 4 pG(lN 0�f ` Occupancy_/
to IWe%Ailpied only as_ I Parking Space Z_
in.accordence with Plans, Specificati ns and Ploi-plan filed herewith. Fire Sprinkler
��-s er. Elect.
Estimated Value of Improvements,
1 certify that in The performance o4 th o which s r i s d s Il employ any person
in any manner so as To violate too wor an's mpanset on la sof e. orni
Owner
n t pE Address
gyen Address
RECORD OF INSPECTION !'l, 60WN
Foundation " �/ Frame
Stucco �� Finish7-r�J r
n /O 9' 6 S� GY'��` 260-601N
BOLLINGER"BROAD DE[�TER B ILDERS
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 #.27-00y
is in full force and effect and properly authorizes this application.
San Joe City Business License # / Q
-771� )
280-601 N