32905 1148 Derbyshire
CITY OF SAN JOSE , BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Dafe- / l� ---- _ .............. 19 ermit No.. a .....
Application is hereby m e foq a permit to --:---------.-... ------------------------------------------------
-----story,
-----------------------------------------------story, T e---- .........................................-------------------- Building
nv
---------------n
to be occupied only as (./ - -- ........
in accordance with Plans, Specific ions and Plot•plan filed herewith.
Estimated Value of Improvemen �$//... -..-
It is hereby agreed that the requir mor@✓of the'-s' Building and' oning 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 perfor ance of the work for which this permit is issued I shall not employ any per-
son in any ma er as to violate the workmen's compensation laws of California.
t�2 l!GL A `i / y
Own � ' ..CC--- Iddres
-.. -----. ... Z. - .....,e,� =Zr -�' Addres/Form 280-11149° � try5tf�i°re
RECORD OF INSPECTION
Foundation
hL4vL - Frame 5. ----------------------- is
--------------------------
Stucco -------- ------------------------------------------------------ Finish -------��-o
a -71