37463 1107 ixaii fi4e' �z Z
CITY OF SAN JOSE BUILDING DEPARTMENT
12 ZAPPLICATION /F BUILDING PERjMyITG
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Application is here�by�m dee for a permit td/..-....//."-......._....._..._--._------------------_----
a------{/"---.-story, TYP�j-,- .%l...... •5.--- ----- ----Y-'---------------`------------------------- Building
at
to be occupied only as (
in accordance with plans, Specificati / Plot it
Estimated Value of Improvements, $ ----------s ----------- .-------..
If is hereby agreed that the requirements o4 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 issuad I h 1 not employ any per-
son in any nn r so as
viol�ate�the work/men's compensation laws of Califo nib. ��
Owner .. - /,/'lLt4
B - - '.. - �---------------------Address -' -=------------------.....-....------
Canir or, Agen}
Form 280-1
RECORD OF INSPECTION
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F o U n d a fib n ...... ---------------------------------/Frame - ------ ---- ---
4ucc Finish
o ------------------ ---------------