42571 C711*40F SAN JOS P"en Leaf 'Dr. BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
TractNo- -------------------- Lot No- --------------------
Date...................e-7 ------------- 19 62 Permit No.-4.1-S.71---- ---------
Application is hereby made for a permit to App------To.............................................
il�a7------ ------------------------ Building
a---M-t----story, Typea. /4G+1.. ----ll 1?�%se Zone ....X71.------
a+
...X771-------
at Occupancy -------z------------
to be occupied only as -SM�410.dj& CL, 2--------------
* - T, P
in accordance with Plans, Specifications a PC�plan-'ded/here
Estimated Value of Improvements, 2" =----------
It is hereby agreed that the requirements of the Son 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 inner so ,a, to violate the workmen's compensation laws of California.
Owner Address 7-5—u4"1 Yre�y-- I/..................
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Contractor
ByAgent-----------------------------------------------------------------Address --------------------- ------------
Form 280.1 7544 Fallenleaf Ll P.W. Krowne 60",-40/wr
RECORD OF INSPECTION
Foundation ------- - .... ---------------- ------- Frame ---------------- ---------------- ...........
Stucco ------------------------------ ----------- ---- Finish