40506 �h'Y''OF SAN JOSE.Qsty, ZT , BUILDING DEPARTMENT
APPLICATION FO BUILD�I PERMIT
Tract No -------- Lot No&-. -------
Date---.....----......__..4 2Li---.3.)....... i -. Permit No. -- -0- - ...........
Application is hereb a for a permit to -�
°......../-..---sfory, Ty p :. ..-- -- --- -----'... ...... ...... � ------------- Building
at /- - ----i2=t2'' _- se Zone ---_--....._.......
-- ----
Occupancy --------------`--_
to be occupied only as .-.. 1 ... ' g�
h� 'v fY ac ........
in accordance with Plans, Specif c�+ions ano��ot�plan file�rt .
J
Estimated Value of Improvements, $...../.._ ._o�/
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 perfcrmance of the work for which this permit is issued I shall not employ any per-
son in any manne so as to vio-lateehhe workmen's compensation laws of Celifcrn' .
Own( /e'r'r /�_---�.��/.------ ess� y '�G. - ...�.....`...
Confrac" ,
Bynayd .:. _ .---Address,. .. ..^.. -' - - .-... ......... -
Form 280-1
RECORD OF INSPECTION
Foundation ----1 Pate -1 -
- --- -------........................... ..�Fra .........�--/ �
---- ----- ...... .................
Stucco .... .............
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