34441 1565 H&Ath6ri&d �1
CITY OF SAN JOSEGo 79 BUILDING DEPARTMENT
APPLICATION: FRWDING PERMIT
Date. ------------------------ Permit No. --------------
Application is hereby made for a permit to 0)0/----------------------------------------------------------
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CType---- -------- h4_6bb-----------_---------- Building
All
at --- Zi
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to be occupied only as -----------�1�;_Pl
in accordance with Plans, Specifications plan/t/dUr Ut
Estimated Value of improvements, 1!74,.O...�6............
It is hereby agreed that the requirements of the San Joss 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 manner so as to violate the workmen's compensation laws of California.
Owner /"- ...........
.lei 5� IFLI Z Address --------------------........
ess ...............................
By 41 . ........ ddr --- ----------------------
ontrit
to
P- ?980-I7
? ref'a�&rwood Eugene De La Cruz
RECORD OF INSPECTION
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