39498 M-OF SAN JOSE01iff Ord BUILDING DEPARTMENT .
APPLICATION FOR BUILDING PERMIT
- - Tract No. .................... Lot No. ..5� ..._...
Date....----. wf. " . . ......_-- Ig..�.Z mit No.3..9...q--?` - /
Applicatio� is hereby made for a permit to )1..._1��5 4
a----------1-----story, Type ... ------- k,--.. ... .. -'-------------_.... Building
Use Zone ......
at at ..:b7.al-V........(P........ .. ...... .. .....: .. Occupancy
to be occupied only as .P.. . ...... ... . .. . Parking Space ......3.............
in accordance with Plans. Specifications and P Ian fi ' t
Estimated Value of Improvements, $........��..:5...(L.��.........
It is hereby agreed that the requirements of the San Jose Building and Zoning ordinances and all other
lows applicable to the construction, location, and use of buildings within the City of Sen 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 toff iolofe the workmen's compensation laws of California.
Owner m (�(do lOvt-----I.IheuP�1.RI........_Address
.... . ....
Contractor � .
By Aycat-------------- ..Address ----------------------'----....
--"----------- -- ----- . .
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Form sae-I 6728 CL fford Dr. M. Clayton Henry 7- 4-4- 3
RECORD OF INSPECTION
Foundation .---------- ------------
--------- --------------- Frame .._------
Stucco
.... ------Stucco ----------------------------- --- -- -----------------.- Finish
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