35967 CITY-OFA SIN JOSE BUILDING DEPARTMENT
L02.0—APPLICATION FOR BUILDING PERMIT
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Date.............. .._.......... --..............195.-...... No._4
Date
Application is hereby made for a permit +o............bU�"ild d................................................
V $eaidondG Building
a---------OII® s+ory, TY e-------------- --------...........---.....-----------...------------I—,------........ g
a+........Lot No•:`1 I'f_9 a Sua Joseq Calif.
one family d 0111 & gAr� �r�-.
to be occupied only as----------------------------------------- --.........9 .��......-------��.
in accordance with Plans, Specifications and o+- an filed herewith.
PLAN
s
PLAN N0•
Estimated Value of Improvements, $A�_/),_
If 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-
pliwi
th.
5.rfih.fy that in the performance of the work for which this permit is issued I %hall not employ any per-
son in any manner so as to become subject to the workmen's compensation laws 'of Calif rote.
EIC 03SEB• �NCie 2001 El GGM ROal
Owner.. .... Address - ... `......... ................ ----
..... .....
Palo AltoCalifornia
. . .......... ....Address:..-----
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.......... -------
- - ... ....
ConitectoL Agent_
Form I00-I • • r`31�.
RECORD OF INSPECT!PN
Foundation/.!!�.
F no
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°-----"'---------------------------- ..............—...........Finish............
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