34671 00 6616hy llitI6 37
CITY OF SAN JOSE �,BUILDING DEPARTMENT)
APPLICATION FOR BUILDING PERMIT
A
Date---/-- ------------------------------ I qtlatL--- Permit No. ..........
Application is hereby made for a permit to -413,&/n-.../---------..__--_--------------------------------
a---------
--- ------------------------------------------------
---------- -----story, Typet--------------------- Building
to be occupied only as -----/rr:'054-----------
in accordance with Plans, Specifications ancIN&Ian'A, ;Wila�
Estimated Value of Improvements, $---16.010-Q-------------
It
---16.010-0---------------
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 ...............................
By _-_---------------
..............Address, -_ ---------------------------------------------------------
L2?nfrfor
I. A t Newman e� Vierra
�farm280.1 10 o—OX� Hills
RECORD OF INSPECTION
Foundation ------ &lv eg-er--
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