40506 OF SAN JOSV�aBY7 / / BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract No. (J .:..... Lot Nof!:./._ /�--------
Date....---------------------�.. ..3./. 19( Permit No. -
Application is hereby made for a permit to .'....`. ............................
a-----,.....story" T I-"---' -' J ' - - --.. ..- -��%� .....--------..._....---. Building
9s_
�. Use Zone ._------------------
. ............
Occupancy ...-........._------
to ba occupied only asZ—__,-7-.. .. .. ...� �/ P r ' pace ------..._._--------
in accordance with Plans, Specif 1 .nd PlPlo�fi fif
Estimated Value of Improvements, $�../J.
It is hereby agreed that the requirements of the Sen 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 sh not employ any per
,on in any mann so a,.to violate he workmen's compensation laws of Celifcrnia
Ow er C� /� Z��F�Address/19 " 3�. J CIr
.1✓ .
---- . . ..
CenNact9r' ,
ByAa. f. .. . . .... ..... ..........Address i / ......... .......... . -
Form 280.1
RECORD OF INSPECTION
Founda+ion ----- _-G.S-C.✓.- ------- -Q.,. .--- a ... . ------------
-- Y � � J.-----
Stucco---......__.----...--------.._-----------------..... Finish ... --------------------------------------------------------------