48210-F 1234 Belknap Ct.
CITY OF SAN JOSE BUILDING DER RTMENT
APPLICATION FOR BUILDING PERMIT
Tract No..........?..... LLof No........2-,
Date..........-............. .o.. ..�U 19---1� Permit W4-6��o...............
..QA.1.......
r
Application y a r r I
.0 157, 7 --------------------
... .0000 .....................-.... Building
yp .....f . . ..... ........
a-..-.............stol ......
Q
Use Zone........................
at �.. ..... ......�n �......k. �
I ......i. Occu ancy........................
--- ------------- --- - L ,
to be occupied ai,��..r....:2JA arking Epace........................
in jl�,�s,,,SpecifjOT/-ns 'n n I a �h\
m ro -;&f
Estimated Value of mprovemenfs,$........... ...... ..................
It is hereby agreed that the requirements of the San Jose Building 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 permit is issued I shall not employ any person in
any manner so as to violate the workmen's compensation laws of California.
Owner.... lt'. Address...a
Contractor
By Agent--: -......`'fes ��Add7Tif
......... ....
7..........
1234 Belknap Ct. J.A. Shrick
RECORD OF INSPECTION
Foundation.z/2-�/As--:� ..I-----------------Framer .............
Stucco------...............------------ -------................Finish........... ......
FORM 280-1 -IOM-2/65