40506 1171f._. .,.. bre" � -'ii2 ,b `!
CITY OF SAN JOSE 7� BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT .
q Trac+ No.3O.Z/. ... Lot No. -------
Date
.....- 1y' nn C]� r
Date-------------------/.2........1-1....... 19.U:� �{ Peerrmit No....../.-:.:-60.6-4--_..
Application is hereby made for a permit to -N:.��C
a---------Z----story, YP T e.f'... -Q.s..: . .. Buildin�
Use Zone
�.-- -----------..............._....pp.. pp
at
.�1'.. ....I�.'.
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Occupancy .... ----------
to be occupied onlyas ......... � Perking Space -----�-. --------
in
.-
...
in accordance with Plans, pp c �os/ d Pf t- art-ftfej erewifh.
Estimated Value of Improvements, $__� 5._ .....1 . . ...
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 par
son in an ma ner so as to iolate the workmen's compensation laws of Califs rni .
;s
Owner _ tir y �.--- ...Address/ddress��.tli C`'a
Oonfra<tor
......_..._.. : _..
Form 280.1
RECORD OF INSPECTION
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Foundation ----1.. 7- 63 ................
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Stucco - Finish --- .......r —-------------------
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