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Tract No 3S Lot No.�
CITY OF SAN JOSE BUILDING DEPARTMENT
C� A PLICATION FOR�UILDING PERMIT
0-1/S
Date— 19� _ Perm} o.
Application s hereb made for a permit to.
a
—rstory, pe uil in y�-�-�---Use Zone
/vv Occupancy
to be occupied only as
arks Sp ce
I e r Inkier
in accordance with Plans. Spa rcations and lot�p�enOi� er - mer. Elect.
Estimated Value of Improvements, $4 5
I certify that in the performance of the work fo which Phis permit is issued I shell not employ any person
;W
n any mann to at fo violate the workmen's compensation law �(,�giiz cO t St.
$•r.4
Owner 0 DEROSIO S Address o v1
co
By Address
p RRECOF INSPECTION
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