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CW OF SAW JOSE'- L BUILDING DEPARTMENT
APPLICATION /FOR BUILDING PERMIT
Date..L..._ .. .-- ... Ip0o- 7/ Permit No.. _� /r(--------------------
Application is hereby�tade for a permit to'. n.(-----..........._.._---------------_......_----
a----- ------storY, TYPE'r//`��-S-....--------...- /�---•.�_.....--" ---------------..... Building
+o be occupied only . QAr
-
in accordance with Plans, Specifications a -pla( C( 6
it er
Estimated Value of Improvements, $�VL� --•
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 astoviolate the workmen's compensation laws of Ca liforp1'.
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BY Cf I--- T "-/ "' "G� ....--.Address ---------------- -------------------.... —' --
ContractoEAgent
Fnrm 2A0-I '
RECORD QOF INSPECTION
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