41392 Bubb Pd.
MY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
,3,Z&
act No. Lot No. _55
2,� I --------------o..
Date... ....... ......................... 196...... Permit N .......... ---------- -
Application is hereby made/ for a permit to ---�k................................... .................
0 '*2 2!�W_ ....... _. ......................;�&
a---------------st ry, Type....... 0. Building
UseZ -------------------
at
to be occupied only as -------- 6 ccupancy ----------------------
4%//W/10ka..kVi1ng Space ----------------------
in accordance with Plans, Specifications an Plof-plan filed herewith.
Estimated Value of Improvements, $.........lcp......................
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 per-
son in any manner so as to violate the workmen's compensation laws of California.
Owner avc-;2k4e_1j----- ...................Address .77 ...... ............
Contractor,
*.p....... --Address ....... ......... ..
Form 280.1 1 Brookfield Corp.
KIFfl
RECORD OF INSPECTION'
Foundation ..... - " � 51..-P^i"'�/.., Freme .--..--.._..----- -
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Stucco ----------------------- ---------- Finish ------
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