43892 CITY 91FAA'NkYSSMEO:�5 BUILDING DEPARTMENT
APPLICATION FOR BUILDII s PERMIT let
Tract No:_��-q./--- Lot No.
Date.- ------------------ . .................. 194.0Y Permit' 'N* o.4.3--?7/,j...✓
Application is hereby—made for a permit to --- . . ................. --------
Building
ype 4a,:��
---- - ---------- ----
a---------I------story T - -- ----------
at Zo./.f--/[- .................x Use Zone
panty --------
to be occupied only as ------------- 1"W4�impg Space --------Z----------
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, _Z060clo
If is hereby agreed that the requirements of the San Jose Building and Zoning Ordinances and e11 other
laws applicable to the construction, lo,cafion, 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
manna violet the workman's compensation laws of Californi
'on m a an
---- ---- ----- -
-----Address
Ownea, ...................
Contractor
----Address ----- ..........................................
Form 280-1
RECORD OF INSPECTION
Foundation ... Frame
Stucco ------- -...................__...----.-------------../..
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