NO PERMIT NUMBER 841 1
Betlin
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date....-..../... Permit No.....----!--------------------
Applizion is hereby made for a permit f------13gl.4n.,o--------------------------------------------------
a--------/------.-story, Type`-------............t4
................-........Building
et............. ------------------------------------------------------------
to
—-------------------------------------
...... . ..............................
to be occupied only as-.... .. i ...................
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of improvements, $--- 0
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.
Owner.....V .........
---------
--------------
-- - ------
BY--------
contractor. Agent
Form 280.1
s RECORD AAOF INSPECTION
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