45617 902 EiLazingvrol)d
CITY OF SAN JOSE BUILDING DEPA
J. APPLICATION FOR BUILDING PERMIT
Tract No--------------------_Lot No.---------------------
Date........................;/70�v Permit No._,4�_J_.617--------------
to
Application is hereby ade or p to ..............................
a--------- ---story, Type .. .. .......... ....................I........ Building
at ---?0 Use Zone----------------------
Occupancy-----------------------
to
one----------------_----_
........... --------------
---------- ---
Occupancy------------------------
P -
to be occupied only as M. C. Par i g Space------------------------
in
pace------------------------
in accordance with Pla'ns, Sp
'00004,
4c –A, C14
1 Estimated Value of Improve'lnerif 7..... ............
1+ 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 i within the City of San Jose, will be complied with.
applicable
certify that in the performance of the work for which this permit is issued I shall not employ any person in
ii any manner so as to violate the workmen's compensation laws of California.
Owner... 0-4-----..........-----Address...? 0
..42�2 _.C� � , --r C/,/ C4
-------------
----- ...... ... ...
1_1_;�. .......acto
ByAge ----a,- --,.Address---------------------------------..... -------------...------
902 Blazingwood Loyal Foth
RECORD OF INSPECTION
Foundafion....... ............ -----------------------------Frame........................................
Stucco..-------- ............. .........................
Form 280.1—IOM-12.63