43123 CIW4 9,KAnAWY1(-'�V. BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract Lot No. -----------------
Dafe/�z/_ ---_----------------------- 19. PermitN,._Y31--7-3---I
Application is hereby de for a permit to_%__' ........................................... ..............
a-----/--------story, Ty. - --` /_r.- ------- ------- .............
..... .. - Building
4-------- ........ ---- - ------ -
on.
at ��Occupa,cy --------/---.....--
to
---------/----------
to be occupied only as --------- - ------ ----- ------ Parking Space ---------
in accordance with P ns, Spee' i o sn Plot-plan_fi1,eA herewith.
, Estimated Value of I pro menti,- $../.. ..-0.,i
.... ...I............
It is hereby agreed that t a requirements of t 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 yiplate the workmen's compensation laws of Californi
ddress -------
7/----------
0
Con"c!or -4, 15,
------ -------- ---
BYA9 .....Address �.Z
10, ... . ...
Form 280-1
RECORD OF INSPECTION
Foundation .�-:�(�.:.lL� ..-.(,f Frame
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Stucco --------- - -----