43418 1226 B61kh-no
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT 3M
Tract No. —.3281----- Lot No. -21_...........
41 Date------22.-27-7............................ . ig-63.... Permit No. ... ........
Applicafion is hereby made for a permit to ---------COnStrUCt........:................... .......
a------I----story, Ty e<
......../I
. -- 0
...... ---- --. . . . ...;
dingVBuil
Use Z at ..1226`-Belknap
......
Occupancy ..._..,1.__......
to be occuo. d I a Residence Parking Space .__.z-..........
)e only s ..... . ---- - - -----------
in accor V!q41111,o�ffdt-plan filed herewith.
Estimated Value of Improvements, --------------- -----
It is hereby agreed that the requirements of the San Jose Building and Zoning Ordinances and all other
laws applicable to the construction, locafion, and use of buildings within the City of San Jose, will be
complied with.
I certify that in the pericrmance of the work for which this permit is issued I shall not employ any per
son in any manner so as to violate the workmen's compensation laws of California.
Owner . .......Address- --------
----- -------- ----- ......�%.. -- .�.
Contractor. -Construction—Ad ess ..San..Bpl - -------------------------------
ByAg.rit..5-t-ork.e.s-on.. . t ,,no
William A. Plant,. Supt.e�
Form 280.1
RECORD OF INSPECTION
Foundation . -��_-ri. i�H� S ... Frame 7�7y:.G ��f-r.:fs nH--
Stucco.:..--------.._.....---------------------
-----..._.. .`Finish ../ -/..7.C.�P. .._lcip