402121197i , % _.
CITY OF SAN JOS BUILDING DEPARTMENT
APPLICATION -FOR BUILDING PERMIT
Lot No.
Tract No. � .. ... ------
Date- ........... 19 Permit N,..�/_O .... 1-1-1 ---
Application is here* a a -------------------------------I .......................
d for a permit
--- / --------- stor a ------ - --------- ---------------- :7- ------------- ... Building
y
Use Zone
at----------- --------- .......... .....
--- ---- Occupancy ...................
to be occupied only as ing pace ----- -------------
'4�d 4ewi'
in accordance W Plans, *'-a --------- ------------ Mo
Estimated Value of Improvements, -.^6.------/.....
If 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 sg as A Mate thp)workmen's compensation laws of Califurni J/
4
Form 280-1
RECORD OF INSPECTION
Foundation J u
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Stucco ------- --------- --- --- ---- - ---
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