30838 849 . Grttern� �t
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION �F?01 BUILDING. PERMIT op
Date ... .� . ...... ..195..f.., " "'r Permit No..... .... .fS_ -Q
...... .
Application is hereby me a for a p it to....., !'r�r ...... ..
a------- -... st Y� TYPe------------ ------------ -- - - ----' -----------....-----------------------'...Building
at...... ..... ....... --- -------- ....... . ........... .......
to be occupied only as------------- ""'C ---
in accordance with Plans, Specifications a of-plan iled ere ifh. / 3�
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 nor so as to bec/o�3�9a�s�u�bj/eyct to ha wor ens compensation laws of Celiforn' .
Owner. . . . -44
,� �' .... d
By-------- --....----...k...... _ 4
........... . ...... ..
A
Contractor. Agent
Form 280.1 849 Grimm 6-9 Loma Verde _
RECORD OF INSPECTION
Foundation........ oT 7-3--,3
............................................ Frame ;........ ...................................................
Stucco.................................................................--.Fid nish------- ....................
7 4PI17