41228 CI OF SAN BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract No. Lot No.
Date- .......... 19.16..E Permit
Application is hereby mad for a permit to ..R9V./'Az-------------.. ............----------
a... --------story, Type . ... .... _.eiolvc.......... Building
Use Zone - ----------------_-
at Space
I- ------------------
P,cs
ing S
I-----------------
4o be occupied only as 'e#' 000�§'reging
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value;cif 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 \1
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 violate the workmen's compensation laws of California.
Owner -S.C-H-UL.T-E--...CAMP--DEY,..co Address ---------- -------------------------------------------------
contractor 2633 SO. 13ASCOM
BYA10-t---------4;AMP.BELL,..CALfpCRrqI ..............Address --
------------------------------------ ----- --- -----------
Form 2801
RECORD OF INSPECTION
Foundation ---
------------------------ Fro ... -- - -------------- -------- -------- -------
Stucco ................... ------------ ------------------------------- Finish,............. .. ---------------------------------------------