38046G1TY OF SAN JOSE ' e BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
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Date - ----------- ----- 19.C1 Permit No..... ----------
Application is here�b�de for a permit Y ---------------------------------------------
a ------- / ------ story.
..----------------------------------------a-------/------.story.L —---------------------------- Building
to be occupied only
in accordance with Plans, Specifi ay' n d/P��h.
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 shall not employ any per-
son in any manner so as o violate he workman's compensation laws of Califo
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RECORD OF INSPECTION
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