40212CITYh "y
CITY OF SAN JOSE E 3Y- BUILDING DEPARTMENT
APPLICATION FOR BUILDING -PERMIT
I
Tract N12 Lot No. livl� __F7....
19 7" 6 2.,.1 12.
Date- ................................. ------ Permit No. --y ------------------ ..........
1_0 I . r V
Application is
a--- -------story, Type ............ .......... -------------------------- Building
Use Zone
at --------- Occupancy ...... .... _ -------
Parking Space ..... 2 --------------
to be occupied only As
in accordance with Plans, Specifications and Plot -plan filed herewith.
Estimated Value of Improvements, $1115—e. 0 A--
--- - ---------
It is hereby agreed that the requirements of the San Jose Building and Zoning Ordinances and .11 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 s)ail not employ any per
son in any male t *01ate P0 workmen's compensation laws of Califer!iy
7e7�AA Addresv
Owner------- - --- - -----------------
Coneactor
9. ........ Address --------- ---
--- ---------------
Form 280-1
RECORD OF INSPECTION-7
NSPECTION
Foundation .._..._LI'
-------------
Stucco ..... ------- ---------------- ...... ---------- 416� .... Finish
G7