38046 il, 4
CITY OF SAN JOSP'�'�"'6��Or're� PIA" BUILDING DEPARTMENT
APPLICATION FOR BU ING PERMIT
Date-""/ --------------------------- -- 194--z- -Permit No. 3.3.61.40..............
Application is hereby de for a permit f o --------------------------------------------
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- - ------------------------------ Building
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to be occupied only as/.--.7.......... .
in accordance with Plans, Specificati )JZF;��a<Wrn�4ielleed_ iarcw�iV
Estimated Value of Improvements, $------- _6-
-
1..............
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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-
son in any manner so as t violate the workmen's compensation laws of Californ
ZT, &"�_"`_'�Address.�
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By
RECORD OF INSPECTION
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