32009-City of San Josees 9 3 ,�e
F ,:�
CITY OF SAN JOSE BUILDING DEPARTMENT
?� APPLICATION FOR BUILDING ,PERMIT
Date ...... 8 Septa
95---P
Application is hereby made for a permit to......
a ...... 0ae story, TYpe----..........
at.....Lot i7o.Fairu-rove-- ----
Permit No. ..............
build
0. 141if a
to be occupied only as ------- oae__i111V._6Lre111[ku Sc .(y3ra(�8
.
in accordance with Plans, Specifications and Plot -plan filed herewith. 5
PL-- i+sio
Estimated Value of Improvements, $( ...�`'r�
It is hereby agreed, that the requirements 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-
son in any manner so as to become subject to the workmen's compensation laws of California..
INC. Add 2001 U CL= !no
'eel
Owner..... '........ :5:... s ........................... res s..-...........-............. --------- ...------------. ------------
�n Palo .,ltoo California
BY- " ---=---- ------ - ---- -- I` .� . �7...i........ Address ....................... - --
Contractor, Agent �\.
Form 280-1 A. Lo 4F -`&R0 `�— "
RECORD OF INSPECTI9N j
............ — —....-----.._ ..................Finish------
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lo 94 0
1