38151 8W OF SARI JOSE0-119"h�err"13'1 311LDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date,/ / ?/
---- ...- 19-c, ---- Permit No.
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Application is hereby made for a permit 40�
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to
--to be occupied only as/=_�-.._.�.�..`." �...:--..
in accordance with Plans, S}Ye_c ca"{ionnn,eP
are
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Estimated Value of Improvements, $1 ..........................
It is hereby agreed tha# 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-
son4�ny_ma,��,o/as }o violate fhe workmen s compensa}ion laws of Ca ornia.O --.Address/�.�� C.BY � �F Address) - ----------
Contractor, !gan#
Form 220.1
RECORD OF INSPECTION
Found fiwe-�CL-A—k6--- Fr , - T ---2—
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