33108 ilaC Way
CWF SAN JOSE BUILDING DEPARTMENT
APPLICATION FORVILDING PERMIT
19 / 47
Date.....-- . ........................ Permit No.-13020-1? ..........
Application is hereby made for a permit to -04;1�---------------------------- -----------------------
a........./..---story.I Type----�2----&51161 1-111 ?0-111 ----------------------- Building
t Zclo---C... ......
to be occupied only as ... - ------1l
-----15,
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 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 par.
son in any manner as to volae the workmen's compensation awj of California.
Owner
Address
ner ------
By
.........Address ......
pnir c ant
Form 280.1 tl, ac Way //9d
RECORD OF INSPECTION
Foundation ------ Frame-
Stkco -------------------------------------------- ----------------- Finish -------------------------------------------------------------------
3 7.2 )�
5123 /