36160CITY 07F 5AN t OS iI� �� 6/ BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date. ------- S1 6;----- ----------- 19---G'- - Permit. No. --- 3(o I lv C
i
A/pplication is hereby made for a permit to-----��6.--------------------_--....----------_----_-.------
a------r-------story, TYpeZ7_ ,?S,:- -----------iT--------------------- Building
of .-- ,1------j=1UN/. lllbL`-..L(CHzur_� ,F
77,JS _
to be occupied only as ..-1---- .--�----------
in accordance with Plans, Specifications anPfof=pl ifed e'h �ev/tth.J-
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 s',o//as to violate the workmen's compensation laws of California.
Owner -- ----- Address ---�6�aT ......
�o F27 u / d Lxc- G.S� `..----------------.....
BY - a -- a=L...G - .Address -
Contractor, Agent
Form 280-1
RECORD OF INSPECTION
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Foundation[-,
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Stucc . ...... .....
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