33364 7775 LiIA6 Way
CITY OF SAN JOSE LcT /f - BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT Fo3
Date-----------`7-----------------------------------119 Cf Permit No------- G / ------
Application is hereby made for a permit' to --/vim- _,J>---------------------------------------------------
a-....-----,---story, TYPe-- ------ - - -'--------� ' '----------- Building
to be occupied only as .-.,1...---- -- - -------------- ��
in accordance with Plans, Spe ficatf� afid/Wot plan � d'h6 ewi
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
complied with.
I certify that in the performance of the work for which this permit is issued I shall not employ any per-
sonin any nC as to violate the workmen's compensation laws of-California.
Owner Y` .Address IJV`^\-- 3 `....4
-- .-.Address --------- -.. � �C%
Contreetor, Agent
Form 280-I
RECORD OF INSPECTION
Foundation --- Frame
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Stuco -------------- ------------------ ---------------------------- Finish ----- ------------------------------------- ---------------373Y-,3