31276 892
CITY-.OF SAN JOSi L4�_7sl _ BUILDING DEPARTMENT
J, APPLICATION FOR ' BUILDING PERMIT
Da .........................I 19,,:�7__--- -Permit No..112.;�40---_------------
WApplication is hereby made fora permit to_... 56. ...............I...................................
a — ---- story, TYPO .......Building
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at............................ ......... . ........................
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to be occupied only as....: ..... ...
o
in accordance with Plans, Spec i t, Xof
-pla0 '7 -----
Estimated Value of Improvements,
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It is hereby agreed that the requirements 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 earn-
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 wgrkmen's compensation laws of California.
Owner. ko,,�, ---kle,�6a,Ad d r e s s 112-7a6e xz/...
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.. ............Address------_................................. ........................
Contractor, Agent
Irm t§2 Grimm 5 *f Loma Verde
RECORD OF INSPECTION
..
Foundation. ..
. ........... .... ---F a . 9-70/
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Sfucco..............................
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