37583 1'04
CITY OF SAN JOSE BUILDING DEPARTMENT
PLICATION, M BUILDING PERMIT
Date ///. --------------------- 19 Permit No.l_75-- Jl 3------------
Applica#ion is hereby me e fo permit
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to be occupied only as
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in accordance with Plans, Specifi 75nd P1 W-plr.4
_2� e ��th_
Estimated Value of Improvements, -----------r----- -----
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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
al
son in any m er so/ds to violate the workmen's compensation laws of C for"i
1. Zz'd�eo ..Ac1dress,:/,/2'(- -r _�T"'
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By ---- ----- -- - -------- ----- --- -----I------ ------........
Contractor,
C_ on I
RECORD OF INSPECTION
Foundati.on
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Stdlloz�;�P"') Finish --------
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