43123 oll 4ibrA66ft6v �Dikz
CITY
OF SAN JOSE /r BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
4
Tract No?T!Y.4Lot No.4�.... ......
Date.4< Permit No.------q...
. hereby d for a permit to ---------- ..................... ...........
a------F--..story,
is ere y -me a - -------- ----
a-------/....story, Type-- ------- - -----4— ......
------- --------- ...........---------------- Building
at --- ....... ..I.... ........11-------------- . ..... Zone ---- Z
Occupancy ---_...L------....
Z_
to be occupied on as/.. .. ..... Parking Space .......... . .......
............
in accordance w f h Plans, Spa ' icat' s of-plan filed herewith.
Estimated Value of Improv a , $.L - -------1.1.............
It is hereby ogre that th requirements of th San Jose Building and Zoning Ordinances and all other
laws applicable to th ruction, location,
location, an , of buildings within the City of Son Jose. will be
complied with.
I certify that in the performance of the work r which this permit is issued I shall not employ any per-
son ;n any manne '_to "'late the workmen' compensation laws of California ce,
0
Address
Own �caatr.aror ,l"�,' AddressZ
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For. 280-1
RECORD OF INSPECTION
Foundatio n ... Frame
Stucco ----------- ---------------
......... ----------------- .................
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