41495 CITY OF SAN JOSE-V6hhispdrt DftV6 BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract Lot No. -1.5---------
Permit No.411S'f.?r...................
4)
Application is hereby made for a permit to ............ ............. ............................
... .... --------. Building
a....Z...story, Type. 'V Use Zone _/f77nJ........
//Y/3tiH/JIKT�Zsf'
pan y -------
Sp
at 4F6!ff
to be occupied only as a,,
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, ...........
It is hereby agreed that the requirements of the Son Jose Building and Zoning Ordinances and all other
laws applicable to the construction, location, and use of buildings within the City of Son 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 any manner so a, to violate the workmen's compensation laws of California.
Owner ..... Address -------------------------------- - - -- - --- - ------
Contractor2 3 O. BASCOM- BASCOM
ByAgont-------------
X31CCALIFORNIA..........Address ---------------------------------------- - ----- --- -
Form 280.1
RECORD OF INSPECTION
Foundation ---s--_4;?-.
----✓--- --- --------- .... .. Frame;,.....q--j-i.' A-/""""'----------Stucco --------------------------- -
... <,� --------------------
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