40212� OF SAN JOSE an !0,1/ � BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT ,
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Tract No.3---- Lot No. �------------- r) I
Date!1---- -----------------------------------, 1�7--.� Permit
Application is hareWMade for a permit toj..-.-�P................................ ................
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y
wld
p
s J --i Use Zone !k.� �.---�._'..-
to be occupied only as/... t. .. -----.:. er�arking $pace...._...........
in accordance with Plans, Specifications and Plot -plan herewith.
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Estimated Value of Improvements, $.....5......1..........
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 an nne so as o Violeta ha workman's compensation laws of California %' (j
Owriet- �4C Address"G 6 r ........-------- ........
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ByA9eM�/i....Ff� !/ � ------- Address .. - -----------
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Form 280-1
RECORD OF INSPECTION'
Foundation ... ... SNS__---
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