33029CITY OF SAN JOSE BUILDING DEPARTMENT
..APPLICATION FOR BUILDING PERMIT
33 61��
Date--- --------------------------------------------- ler it No . ................. --------
Application is hereby made for a permit
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a -------- / ----- story. Ty
--------- ---------- * --------- Building
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to be occupied only as/6f
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in accordance with Plans,
S e i;S I s and XIAI ; W
Estimated Value of Improvements. /,9 povi -------------- -
it is hereby agreed that the requirements of fee 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-
son f C hf a,
son in a annbr sQPA o violate the workman's compensation laws o a i orn
ze
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0 e . . . .......................... Address
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By ---- ------- I ---- ------------- 5� ........ Address ....... 7.....
Form 28 113�01MS`Fb 'ire V6_e d RJ. Hunter
RECORD OF INSPECTION
Foundation .y -D.' ... :7tC �t�Frarne
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