40113CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING-JRERMIT
�j Tract No21' '--7 U Lot No. 1�2.................... I
Date-/,/-------------/-f-----------------I 1 -
7 emit No.. f..Q...L.L. ----------
Application is her$k{Ylnade for a permit t6�......... -------- .
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at
to be occupied only as
Use Zone
Occupancy
Parking Space
... Building
in accordance with Plans, Specifications and* Plot-plan�d herewith.
Estimated Value of Improvements, $//..(L.......__.
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 perfcrmance of the work for which this permit is issued I shall not employ any per
son in any manger so as to olate the orkmen's compensation laws of California.
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-_f ...�Address
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-------':-Address ' ---...-`--/--------'-------------.......
Form 280-1
RECORD OF INSPECTION
Foundation .... - ------------------
Stucco------------------------.----------------------- Finish .......
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