916427933 OCTOBER
Tract No.
CITY O N JOSE
APPLICATION
Date 29 , is
A afion is hereb mad i fo,r ya
a _/ story, Typ
at 79 -1,3
to be occupied only as
in accordance with Plans,
_ Lot No. URC q97
BUILDING DEPARTMENT
FOR BUILDING PERMIT
76 e ._:. ti_ 9i
Zone
Estimated Value of Improvements, ; `- j
I certify that in the performance of the work for which this permit is issued I shall not employ any person
in any m nor so as to viol to th workman's compensation laws of California.
Own r_ _ _ Address -
BY— "_— . —� _ Address -9'-5� d S
LTJ
RECORD OF INSPECTION
Foundation � _ Frame,
stucco Finish = ------
7933 OCTOBER -,WAY,' I ROGER ANDERSEN , ` 260=601N:'--'
Exemption fr m reel* ials.ftar�, S}ate of Celifarniefor Contractor's License is hereby claimed by applicant:
es own¢ra}em } filed❑Applicant attests }hatte o rnia on}ra ctor's License #
is in full force and effect and properly aufhorizes this application.
Sen Jose City Business License #
-Y— F.QAMf- %Vor ?&woy 2.t5 -7G a
28o-601 N