37463 1145 Hbllyh6 15-
CITY
SCITY OF SAN BUILDING DEPARTMENT
APPLICATION F BUILDING PERMIT
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Application is hereby, as o/o a permit to ----------------------------------------------------------------------
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to be occupied only as '_..�Seii
- -..-' .---in accordance with Plans, ccations and Plot-plan filed herewith.
Estimated Value of Improvements, $--'/1lL�/v
If is hereby agreed that the requirements of the San Jose Building and Zonin 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 ;,n an yoar to viol to the workmen's compensation laws of Califprrta.Ow t ,y � ' Address�4--D-rj-�C-I-P -`-"-- G�-a -- ------- .-y ------ ----- - -
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By( y — ----------------------------- -Address ------------------------------------- -'
Contra/or. Agent
Form 280-1 -
RECORD OF INSPECTION
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