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CITY OF SAID JOSEkOT... ,-......waTNr_-TB-RET ztfn BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date. -:SEP 3 1959....... 195 ..... Permit No.--15/..�b.------------------
conAfruct
Application is hereby made for a
i
permit
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a.....----.`------s+orY` TYPe------ - -------V res ....-----------.-....-------------...------------Building
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einole—fami1 y. r"i.dence
+o be occupied only as..-------------� -------------------�-----....---... ------ - ---------------------....------
in accordance with Plans, Specifi i s a��'Irf a erewith.
Estimated Value of Improvements, $..I--�r.D
I+ is hereby agreed that the requirements of the San Jose Building and Zoning Ordinances and all other
laws'`epplicable to the construction, location, and use of buildings within the City of San Jose, will bo com-
pliod with.
I certify that in the performance of the work for which this permit.is issued I shall not employ any per-
son in any manner so as to become sublect to the workmen's compensation laws of California.
QI�TIT1F T IN,,%? W. I"' Address.--------.--------130O..E1 Camino Real-----... ---
Owner............. Call plenlo Par ,
�) Q ...-.. .. ddress---------------------------DA-3.4118.---------------------
BY- - �i
(/c,ontractor, Agan4
Form 280-I `
RECORD. OF INSPECTION
Foundaiion.... F e
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