43892CITY OANKJOL BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
-Tract No` 4 �...1... Lot No. -5-...........
Date -3- ........ -
/ G ------------, 19-e— -----------
Permit No. --------F-
%Application is her!, yb ade for a permit toL-=- ,.-'�/. -%.-.
a ... 1....- ----.story, Typ/e�� ��- - -- _<_ f/ --l/.. _------------.:..:-------.....
Building
lding
Use Zone . 1 1b.._..
atN... ---------------
J�
�ccupancy------ �-- ---.--
to be occupied only as 1.-.- fi AA � ti6�Parking Space .-...�..---------
in accordance with Plans, Specifications and Plof-plan filed herewith.
Estimated Value of Improvements, $----- -jam... - O V
It is hereby agreed that the requirements of the San Jose Building end 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 oW o v,olafe the workmen's compensation laws of Cali forni �f
Own€r'! ...! -----Address/06 ..�...��------ � / ..
.... /
Contracror - ------------------- Address
Form 280-1 L// r
RECORD OF INSPECTION
Foundation . . ...... Frame
Stucco......---...-------------------------------------1 Finish