78132 7862 Robindell Way
Tract No,2�' / Lot,No. -Vy
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Datenym
19 7� Pgrm)f No. 7
Ak' afiron mi fa_ _ u Use Z e 145f3
at (JtCiG/-f cupancy, /
to be occupied only as �� a 9
in accordance with Plans, Specifications an Plot-plan iled herewith. e
o� Emer. Elect.
Estimated Value of Improvements, $ '3C'(or) ' .
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 violate the workman's compensation laws of California.
Owner 4Vev h2.7 .Pit"65Tr Address X941v
i
By /i R1 164G1 Address 423
64ECORD OF INSPECTION of ALTUS
'✓✓ � 7 Frame
Foundation
Stucco
Finish
7862 Robindell Way Provost
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