33799 7 CI v 'fAN.JOSE 14�'7 2,10 BUILDING,DEPAR MENT
APPLICATION FOR BUILDING PERMIT Qom`"` �' 3
Date.--- .................. . 19,__6j0 Permit No-----5._1.7- F---
q-:....:
Ap ication is hereby made for a permit to .. -----------_............:.. ...... .........
a-----------{....
story, Type...-, ,.. .-...----`........................J.....----.....-`--------'-------------------------- Building
-
at ...... ----Z&31------- �j� [�
to ac occupied only as
lan! . = fica d
in accordance with Plans, ecificarons.and P o e� ewith.
Estimated Value of Improvements, $---��. U........
It is hereby agreed that the requirements of fhe 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
complied 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 to as to 0i-olaafe the
ewworkman's
sccompensation laws of California.
Owner Li rtO-Li VL 1�..11-- U------.Address .T.s . . ...
By ------ (/�`� ---....Address —.....
Form zeo-I 76A7 °r-^gentn Palo Alto Dev.
RECORD OF INSPECTION
Foundation --------- 2 a
---------------------
Stucco ..............................
....... Finish -------
3,P
,E- S-3