31276 8�6 0,4i&6 ki hi r.,�
CITY OF SAN JOSE 6?,9 BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT got-
Date........
711.1r-S.......... 19,-, Permit .............
Application is hereby made for a' permit to.... ------- . .................................:..................
---------/----story, Type----- .> ..... - ------- -------.......................Building
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..................................... - L --- ..... . . ................. -------------
, 797 -- --
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to be occupied only as..... ..........
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, $---
if is hereby agreed that the requirements of 7h.'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 me a as to become subject to the workman, compensation law, of California.
ow 16 1144X_IRIAI,�2
"roc.
By.... . ........Address...... ....................................................
Contractor, Agent
Form 280.1836 Grimm 9_2Loma Verde Jonst .
RECORD OF INSPECTION
Foundation..--:2 ....
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Stucco
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