32905 CITY OF SAN JOS •EBUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date.,)/
------ .............. 19.4 .,-, ermif ------
Application is hereby made for a permit t - ------ ------I------I--//----
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+o be occupied only as
in accordance with Plans, Specifications and Pof-plan filed herewith.
Estimated Value of improvements, $---------------- -----------------------
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 Son 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 in an so_as O'violate the workman's compensation laws of California.
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RECORD OF INSPECTION
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