32677 7509 lwliftriilhart
CITY OF SAN JOSE , BUILDING DEPARTMENT
APPLICATION G OR BUILDING PERMIT
LG
Date... ----------------- —19-tel'o- Perm, 0._------------------------7--------
I
Application is erebby made for 0 if f /&7rM.V1 --------------------------------------------
toa --
--- --------------------------------------- Building
'to T
f
to be occupied only a,
in accordance With lPlans, Specifications and Plot- a filed herewith.
Estimated Val YeTenfs,
It is hereby a- YQaT! he requirements of the San Jose Z2. and Zoning Ordinances and all other
laws applicable to the construction, location, and use of buildings within the City of San Jose, will be
complied with.
I certify that in the performance of the work for which this p u hall of am oy any per-
arm" i5 t
son in any man7f so as to violate the workman's compensation law, of iiforri'
..zl!C...Address
A.)
Ownerou.. 6p.
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By --- - ----- -------- --------------Address ------------
Contractor. Agent
Form 280-1 7509 Bar art
RECORD OF INSPECTION
Fouxd'ation -------------------- - Frame .#,r�
Stucco
------ Finish
3ea *369,