43892 gl
CITY N SAN JOSE v ,� �l /� BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
�m 2 / / S—
//......Trac+ No. ............/. - Loi No.
Date.. .b..- 19.fo... Permit No. ..3-F-71------V
Application is her_eb�-, de for a permit foi".` ..............._._.._..........
✓ ---story, Typ -...- ---------...._........._.--- .... Building
7xs0 �A I Use Zone
a# ....- .. .......................... ' - - ...... . ..............
Occupancy ------------------
to be occupied only as as .. .............._.. Parking Space ------Z..-------------
in accordance with Plans, Specifications and Plot- Ian filed herewith.
Estimated Value of Improvements, $ .-. ... _.._..................-72-000
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
complied with.
I certify that in the performance of the work for which this permit is issued I shall not employ any per.
sonin any manner',ie�s �v�ioolateett a workmen's compensation laws
of California. I
Ow ^ /s/.�v�iiN/i 9� Address/ /' G/t ,
con <ror
Address .� �---------------
Form 280.1
RECORD OF INSPECTION
Foundation S F- ,77�werrame .- ce
Stucco ------ --- --------- -------------- -----------------------AeVinish ........
............