3458560 hhfi ad /-17—& 0 I
CITY OF SAN JOSE BUILDING DEPARTMENT
�j APPLICATION FOR BUILDING PERMIT
/ 1J-- S 19.—,Pei i• ..-..Date . ...x.
A plica+ion is hereby de o a permit fo!`C..f
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---------------------------------- - - ----
t r Tvn 1���S WY_.t' z ------------------Building
to be occupied only as /... - l�> '
in accordance with Plans, Specifications and Plot -plan file herewith.
Estimated Value of Improvements, $l�J---`-------------
It is hereby agreed that the requirements of the San Jose Building and Zoning Ordinances and all other
er
laws applicable to the construction, location, and use of buildings within the City of San Joie,
willbe
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 manntlr soa ,to violate the workmen's compensation laws of Califo�rn��?
O
B ywner/�/' -----..Address/0 :r` - .
/
Add--........................................ress,e: (....
am,..-.. ..
Contractor„ ani '
Form 280-1
RECORD OF INSPECTION
Foundation --------- // ------GO Frame -----
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Stucco 2
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3- Y70 3