28954CITY OFISAN JOSE Brent Dr. BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT 405
L-1-
rX/ -r i 2 7
Date---------------- .... 195--- Permit No.. --... ---------
Application is hereby m for
a ............ I.-.----story,-Type - -----7
to be occupied only as......... ---Y,—/-/ '- -%/..L--k"T-V--CI�................................
in accordance with Plans, Specifications and Plof-plan filed herewith.
Estimated Value of Improvements, $-------
If 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.
VISTA MANOR
Contractor, Agent
Form 2&7-1
RECORD OF INSPECTION
- 1° 1yW