31286Ald6ilbrbok
CITY OF SAN JOSE ' Lot #28 BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
. Date .......... ............. .. 19 59.... Permit No.. ..... ...
---------- I ...... - - - - 11% t 3. / --- *ZR--(0 .........
Application is hereby ade for a er if to .............................. : .........
a--- - - \. L) ---- story, Ty ........ . - -------------------------------- Building
at ----------------- 18 --- 91 ... It C, - ----- . .................................. ........
to be occupied only as ----- (/ ... ) .... ....
in accordance with Plan ',Ihn
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Estimated Value of Improve &S.
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It is hereby agreed that the requirements of the San Jose Building a�d .1 ng'(0,dinanc and all other
I of San Jose, laws applicable to the construction, location, and use of buildings within the �!i y will be com-
plied with.
, certify that in the performance of the work for which this permit is issued I shall not employ any per •
son in any manner so as to become sulblect to the workmen's compensation Ia., of California.
Far. 280-1 861/Lderbr'o'ok Wheatley
RECORD OF INSPECTION
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