40368 illIWOF BUILDING DEPARTMENT
A.PPLICATIO FOT, BUILDING PERMIT
Trac; N76 ;- ------ Lot No. ; -------11'.-5r�
Datii... Permit No-------------------(b...43..........
'7
Application is hereby made for a permi to��_;5A
.....................................................
a__ Z.story. Type��
Build'
... . .... __�41 /-.--.......--------...........
at/ ........ Use Zone'F-
pancy ....=.. ......
to be occupied only as
^"�Ptgu Space'.:**_ —-------
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, -�2C;, -
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.
'on in any manner so as to/violafe thp,workmen's compensation laws of California
Ownge�, ? 7�------------�Zdress -
---- ------ -------------------
---- ------Address ... ... . ....
For. 2801
RECORD OF INS PECTI ON
Foundation 12 / r, I A(� (0
------------------------- ......... me -—--------
Stucco ---------------------------------- --------------- ------ ..--. Finish - - - --------------------------------------------