30656 7625. rjoil, 11
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION & WING , PERMIT
AZ........... 195_t'T Permit No.. jii;?4-1. .........I......
Date...... .....
Application is hereby made for a permit to----- ....................................... .
�dze
.....
a............/....,fory, Type-----.. _...--._..--/-
--------------------------------------------------------Building
I
at ........... . ... ... 5:-1......... ... ... --- ------------ --
to be occupied only as...... ---- ------ -- -- ----- --- .. ..... ...... . .A. ...... ---- --
in accordance with Plans, Specifications aI a with.
Estimated Value of Improvements, $---------------------
It
--- ------------- -----------
It is hereby agreed that the roquirem.nis 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 San Jose, will be com-
plied with.
I certify that in the performance of the work for which this permit is issued I shall not employ any per-
oto b bjoct to the workmen's compensa ion
t, I of California.
..0,
son in a manner SO To
ricir_A� ec T
Y-A, ..Addres
Ow
By- *� 0 4&-* ----------------------------------------------
...Addres .----- -
Contractor, Agent
Form 280-1 7625 Erin Loma Verde
RECORD OF INSPECTION
Foundation.---...... oewzo� 7 �7,1-
........................ ------------....----Rama---..
............... ..........
Stucco.... Z 2
'et— S-Z/ 36