94886 (2) 1120 ROLLINGDELL77 COURT
Tract Not�744'Lot No._�
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date_7��V 197-& Permit No.14L �
Application is hereby made for a permit to
story Type in Use Zone
af _ / _ - Occupancy_l
to be occupied only a �}� Parking Space3
in accordance with Plans, Specification pla e�� r
/v 7 rink
ler
. Electct
Estimated Value of Improvements, ; �O '
I certify that in the performance of the work for which this permit is issued I she I not employ any person
in any manner so as } violate The workmen's compensation laws of Cali rnia.
Ow G Address/ 01""
Address 9
7 RECORD OF INS ECTIO
Foundation 76 Frame -
Stucco Finish
260-601N
Exemption from requirement for State of California for Contractor's License is hereby claimed by applicant:
as orner ❑ statement filed ❑ l/ --+
Applicant attests that his State of California Contractor's License # c2 /—7 /�7 3,� U
is in full force and affect and properly authorizes this ap��plittati n.
San Jose City Business License #
9/l,t✓/7b F � O+� - �1L1��f
280-601 N