32339 CITY CF SWNP JOSE— 61PAI MT
LOT 2�- PPLICATION FOR BUILDING PERMIT
Date......... ° DEC 2...... -�9T �33195Permit No.r�
f . ....-.......------.....
Application is hereby made for a permit to.............build
----------On6..stor Type Y Rosidenc6---------------------- Building
Lot No. (o Ia + ! Jan Jose, Calif*
at.................. - .. .. .....tone
..... .... .. .. ----...._......-- ---- . ...
ally dwelling & garap
to 6e occupied only as.-.-------------------------------- sa ....- ..
in accordance with Plans, Specifications and Plof .plan fit" er' ewit �
PLAN NO.
Estimated Value of Improvements, $.L.h�Q4.4................
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 com-
plied 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 so as to become subject to the workmen's compensation laws of California. I{��
EICN1.7�Aa�PT,
OMS SIC* 2001 E1 Camino
Owner------... ----'-- - --.......---------------.....Address..........................................---------------------
By - , Palo Altoo California
Contractor Agent Form 7BO-1 Ae e s ` d
RECORD OF INSPECTION
Fou -mrafion-- /O._�...-----.......
-- ...Frame........�,
Stucco...V..