43839-F 1199 ELmstord G f
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
/ Tract No. ...........Lot No....... fl1.
f.. .........
Date............... z ....... .................... 19.-fR...T.. Permit No. ..3_.�1-....-....---......------
Ic—
Application is hereby made for a permit to ........ .. ......................................................
a....---.....story, TYPa.. Wlfu, 00( ... . .. ...............................pB_u/ilding
at ------.11�.°.?..... cM.1- -- --4FP10
--- ------------
Use Zone---.....1:..1.........
Occupancy---...a1......- -....
to be occupied only as .....-F-.� ---- _ a .. arkin Space----.._-.............
in accordance with Plans, 5 ecificati a d oe
d r rth.
Estimated Value of Improvements,$........." .. ..............• g
It is hereby agreed that the requirements of theSan 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 person in
any manner so as to violate the workmen's compensation laws of California.
Owner....... ------------- -....Address.....
Contractor,pp p
By Agent...........V� 4410^._/cb�..............Address...af.....IfCl......S!(a�P..............
11?7�<9`Eiae9tai 'R. Wylde
RECORD OF INSPECTION
Foundation...y—. G'l{�/... .(Li(�- -----Frame --
Stuccoow
Foim 280-1—IOM-12.63 -