38046 j iio,1,2'4ty et5f L1486
CITY OF SAN JOSEL� N BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT '/
Date--/ .------------------ 19..... Permi No._.J---80 �- ---------------
Application is hereby m de for a permit to ... ....._......_....--...._--- --------_--------------
a------/-----.stoorryy. T, -- - - - --- -I�- --- ---------------------- Building
..°': ...----------------------- -
to be occupied only as/.`. l - � ��//� /
in accordance with Plans, Specifications and P -pan file he e t
Estimated Value of Improvements, $�. .—�.._O..O
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 as to vio a the workmen's compensation laws of Californiiaa:J C�
O� -----�1/ y�//(/J 6--- -Address/..�G Jl�i�/ cu /
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----'-------L-----------------Address �.`..---
BY ---- -- ---- ----- - ------------------------------------------------
f
, Agent
Fnrrn 7BO-1
RECORD OF INSPECTION
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F d tio --Z-a-2Framo 3 �--o e 'A.-
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e,'
Finis
C,a7 --------------------------------------------S cco --- -�-T Finis