36881 y7C1i"NA 1Ol E1�-4"7 /Pcr)n( ,K BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
G
Date.--
_,/APPLICATION
19----�r ---- Permit No:36--(�..0..�------------------
Application is hereby made, for a permit to -3 44---D---------------------------------------------_...._
a--------1-----story, Type--- -------- rs-------------------------------- --j ----------------------------------- Building
to be occupied only as
in accordance with Plans, Specifications an +•p n ile ewith.
Estimated Value of Improvements, $-- llf-s tJ...:---------------
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 performance of the work for which this permit is issued I shall not employ any per.
son in any manner so as to violate the workmen's compensation laws of California.
Owner�cJ/��rn!.�c•'�`:..�.�SSc�-C'l..rnf�',..-.Address0
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.......-----Addresss�l!�------- .- ' - '
Y� Co� , Agent
Form 2MI
RECORD OF INSPECTION
Foundation .../. 2 S G/C�CsL:c=_Flame _./-L_--- --�-(-----
$+ucc(o �4..L_�- --�./... Finish ...-- - -