33291 ClW8SA�th6i�i466cl t
F JOSE 0t BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date-------Ma,, 6, 60
4�...............................--, 19-----. ...... Permit No...... .......
Application is hereby made for a permit to --------consts-nip-t----------------------------------------
..ein qe
I------story, T e... ...... r c . .. .................................... Building
at ...... 116
-
to be occupied only as agle—fammaijly---dwellin--
in accordance wiV Plans, Specifications and Plof-plan filed herewith.
Estimated Valu �Frcvemerefs / ... -
. t, 0�
It is hereby agreed�., the requir a is 0 'a Id 9* Zoning Ordinances and all other
laws applicable to the construction, location, and use of bumildinwithin the City of San Jose, ,will be
complied with.
I certify that in the performance of the work for which this permit is issued I shall not employ any par,
son in any manner so as to violate the workman's compensation laws of California.
...«..Aciclress- ------41U..Z1...CaminqA- 9-y..............
By1dress ......F-q1c,-A1tjL)....................................
Canl , Agnt
Form 280-1
RECORD OF INSPECTION
Foundation Frame
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