31276 CITY OF SAN JOSE v BUILDING DEPARTMENT
APPLICATION FOR BUILDING- PERMIT Sle-ey
Date........ ---� - 19 ...... P mi, N ...._ -------------
-
Application is hereby made for Perm to ------- ------- ---------------------
a---......../----story, Type---.. ............... ...... ....... ............-........--Building
at.----......-------------------- .................................
to be occupied only as--_ -_ ---- .... ...... ----------- ...............................
in accordance with Plans, Specifications/an Ian f*
Estimated Value of Improvements, $..... ..
It is hereby agreed that therequirements of t;./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 i to b come subject to the workmen's compensation laws of California.
in a so as 0 .
Ow,a dross_///A;P046e"_,�"
By.. Address-------------------- A- 40
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Form 2��0 Grimm 7-2 a-z;P Loma Verde
' RECORD OF INSPECT' ION
Foundation-------- . .---.....Pram .....�21
Stucco.--.......--------...............................................Finish....