31276 803 G +i±p Ki111
CITY OF SAN JOSE BUILDING DEPARTMENT
�fAPPLICATION FOR BUILDING PERMIT SSD
Dafa............./ ..... ......1 19- � Permit No..s31.`e_24----------------
Application
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Application is hereby made for a permit to.... ------.-. ..
a--'-----------story, TyP ----------'---��"f-_ - ...-------....-------Building
at...........................-.........ra/-........ ------....------------........------..........--
to be occupied only as....-f-- - /...
in accordance with Plans, Specifications and PIV-
Estimated Value of Improvements,
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
compeensationlaawssof California.
Address&?7//AQ&ia
Owne
By, .....Address-----_.------------- ~ .
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Con}reco
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Form 2t03 Grizmn259 Loma Verde
a.
RECORP OF INSPECTION
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Foundation.,-/.,-----............. .............. F 2,/ r-p/ kZ43
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Stucco---------------.....----------------------------------------.Finish.....
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