333647791- til&6 WAY I I--4TM� � EN�-
CITY OF SAN JOSE _ I /(P . BUIL i� �GDEPART
APPLICATION FOR BUILDING PERMIT 5-0-3
Date.. - - - ------------------------ 19-6O.. Permit No . .....
.......
Application is hereby m-j�rn-D ..... ------------------------------------
e for a permit to ---
a -------/---------story, lcType-__j . �Building
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—4
-7
at -------- 7 --------- -1-z-424-c- Wq -r
to be occupied only as ------- //4� /;.;,I
in accordance with Plans, Specifications and Plof-plan filed herewith.
Estimated Value of Improvements, $ ---- / 0,e -0 -P -Q ------------
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.
son i any r so s f A a the workmen's compensation laws of California.
a 0 Yo
Owner
w ----------- Ad ress ------
By� -- ---- ---------- - - - ---- ---------------- Address r 41----
C.rtr. or. A'j. nt
Form 2804
RECORD OF INSPECTION
Foundation--(G'-G-{>--_(i--_��aPw Frame
S+kco ----------------------------------------------------------- Finish
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