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33039 bAAtkW._.S%_..._.._WESTLYN #2 TRACT 2168 CITY OF SAN JOSE BUILDING DEPARTMENT APPLICATION FOR BUILDING PERMIT Date .. ........................... Permit ........... CONSTRUCT ----- i " i" by made for a permit to.......................................................................... Application is a--------.`-------.story, T 0; ........................-.Building ... . ..... at......... -------------------------------------------- ....................... iING E F ILY RESIDENCE to be occupied only a E ------2.... ---------------------------------- -------�p...... in accordance with Plans, Specific 10 Estimated Value of Improvements,. ..,- 2-10,0a....... It is hereby agreed that the requirement, 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 com- plied with. , certify that in theperformance of the work for which this permit is issued I shall not employ any per- son in any manner so .1 to become subject to the workmen's compensation laws of G�lifornia. Owner--- ------ ..... - -------------- .............Address----/_�-_, ..?;�C121 By......... ........Adclre's.. 44_. _, Confractor.kA ant Form 280.1 RECORD OF INSPECTION ---------------------------- sf,\co................................................. n s -------Z- z7, ---------------------------------------------------- ----- ILI