40020 C OF SAN�"8�PYX IV BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract No.17-0"7- --- Lot No. ......
Date .... ...... ... Permit No. --
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Application is hereby made, for a permit to '157----------------- .. ..... ............................
a-- 4 -.story, Typ ... ..... -;'0 -1
tf__� - - -
---- --- ........... Building
47de, ar Use Zone ..........
at ------ --------
'an Y ...... ...............
00't/ SP
to be occupied only as-/....----- 0011!V045C�n Space ----1.1-------------
in accordance with Plans, Specifications=and Plot-plan filed herewith.
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 Son Jose, will be
complied with.
I cedify that in the performance of the work for which this permit is issued I shall not employ any per-
son m compensation laws ,f C I'f , ) /
0 A
Address/Z.
A Address ---......... _`' --+----------------------.....
Form
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Form 260-1
� � RECORD OF INSPECTION ' '
Founda#io -. _-«,-��-s. !d _*- 14-2 .7- 6: LAW
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