38046 OITYOF SAN JOSt"_�" 3' BUILDING DEPARTMENT
APPLICATION FOR BYADING PERMIT
Date---
------------------------------ 19----------- r rmit No. 04-9...............
Application i hereby de f a permit to ---- -----------/j----------- ----- -------------------------------
------- ----------------------------- Building
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to be occupied only
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in accordance with Plans, Specificaf p if
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Estimated Value of Improvements,
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 not employ any per-
son in any manner,d,o as to yrolate the workmen's compensation laws of Californiae/
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Owne
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Agent
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RECORD OF INSPECTION
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