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CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
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Tract No. -i��.'_ZLI_ Lot No. �T ------
Date -.///--------------1 01 .................. 19 Permit No . ......
Application is 'e"r . ...........
0 ..................................... -- ----------- --
a -------- lz.story, Type - ----- ......... ....... ... ... ...... .......................... ---- Building
at .......... Use Zone
Occupancy .....=----------
+o
.... = ------------
to be occupied only as./a7 --- 7 ....... W-1 ------ Parking Space ......11. -----------
in accordance with Plans, Specifications and Plof-plan erewifh.
Estimated Value of improvements, $.,1an fil115-0) C
. ......................
It is hereby agreed that the requirements of the San Jose Building and Zoning Ordinance, and all other
laws applicable to the construction, location, and use of buildings within the City of Son 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 mefner sVs/A the workmen's compensation laws of Cahfcrmy).
Oc
own,g�� 0 .
ByAg.ni ... .................. - -------------
.... ........... .... Addresv'�
Contractor
----------
_--------------- Address
Form 280-1
RECORD OF INSPECTION
Foundation ---.-ll - - F ... ..-1--.-2-----.-.--.-.-.-.-.e... .3 -A-- - --z-----e--z
Stucco ------ ------------------------------------- Finish ........6----je3 awv�
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