40020 OF SAN
BUILDING DEPARTMENT
%�AZLICCATION FOR BUILDING PERMIT
Tract No. Lot No./Z. .....
Date
--------- ----- er t No...4000A.-, ---------
.t tq��Mi
Application is hereby ade for a permit .................................... ..................... - -
a_...-/---..story,
. ..a----- -//--,:.story, Tyre_... ..... :E. ..... ----- ......................... .. -------------- Building
at -�.;. Use Zone ......
.............. ......... .. --------
to be occupied only --------- Occupancy ................ ....
................ Parking Space ..._7r......_.._.
in
----11-------------
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, ............
It is hereby agreed that the requirements of the Son 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
complied with.
I certify that in the performance of the work for which this permit is issued I shall not employ an, per-
son in any manner)so as I V iol fe I i a workman's compensation laws of C I's a
4"]w
Ot
Addres,4�..6.Y-'2-- ------------ -
-7 `(
a, - --------
...............Address, - ---- --- ... ......
Form 280-1
�RECORD OF, INSPECTION) Q ��
Foundation ----- -- .G J.�-.4-too I Z."Fre e --..1..`--.7-6_.2--._Lv)
54ucco --------- --------------- _..._ -------- ................... Finish ----------- ----------- ----- -------