46837 1.1.19 Hollyhead
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT '10-
Tract No.........._..........Lot No......-----------..._.-.
Date......I/ 2
..... _7................................. 19=/'s..... Per 0.- ...y t/, F3 7
Application is hereby made fora ermit to
;�g,z, ----
a-------?........story, Type-J ................................ Building
at _AO..... . .. . -------------- Use Zone--..R.=.1.... ....
ncy.......I-------_-----
v .. .... ace.... -----------
to be occupied only -/- _/ e/Vx104TrA1SP;
in accordance with Plans, ?pacifiations and Plot-plan file herewith.
Estimated Value of improvements. $.Yb.04L.�.
--------------------
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 theperformance of the work for which this permit is issued I shall not employ any person in
any manner so as to violate the workmen's compensation laws of California.
Owned!
.f .................................. ..
. .......Address///?/*---�i;_ .......
.t
Contract
ByAgent.:7....V Agent.:................. ..................I---------------------Address........................._........__----------------- .......
1179 140111vhpid R. E. Mumbower
RECORD OF INSPECTION
—
Founda+ion----- ......... ........... c---_--l_ply--- -
S+ucco.��A-�.�..7/a 1 _:.-..-... Finish/../2—/—/
gGJ- 'iF RRGT6�'S
>o L'.JQ 9/0 c_,Crc,
FORM 280.1 -10M-2/65