NO PERMIT NUMBER CITY OF SAN JOSE BUILDING DEPARTMENT
LOTea-APPLICATION FOR BUILDING PERMIT
Date-.. $ Jepte -----_----- ------- -195---- Permit No..��—Z�� ...............
Application is hereby made for a permit to----------build ,
�J .....................----------------------------------
at o-neC---.story..., Type .-. /.f� --------------------------------------------
Building
Lot Noe 78 rgTovo e Faia No; 2 3 S Czlife
one rr^aui irellin� & +era}
tobe occupied only as----------'------------"...------------------------'a-------{''-----inmp-------------------------------------
in accordance with Plans, Specifications and Plo#-plan filed herewith. . 16"
-
/ , II0.
YL;SI
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Estimated Value of Improvements, $1.���0--
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 shell not employ any par-
son in any manner so as to become subject to the workmen's compenietion laws of California.
'ICI : IIOMl. : IIICe 2001 � C:rJino -teal
Owner- -- - '- - ,- - ... ..Addre3i---------.-------------------------------------------------
Owner
' El -......-- ............:
#'al.o Alto9 C-----------------------lifornia
Address ..:.-. -
Contractor, Agent - ---------------
Form I80-1 Aa, Le jHAP _.
4iti�� RECORD OF INSPECTION
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