32975 725 + L> 6d
CITY OF SAN JOSEt, BUILDING DEPARTMENT
zz APPLICATION F?R UILDING PERMIT
--' +� /�
Date- _-- -r----------------------------- 19-&U Permit No........r1.0'.=l_7_.�.......
Application is hereby made for a permit to -----F`-_p� ------------------------- Building
a - ......story, TYPO - ... --�---------------------- g
at --- --------------
to
-----------to be occupied only as ..... F ..... ......
in accordance with Plans, Specifications and Plot plan filed herewith.
Estimated Value of Improvements, $...1.2,, So.o.......
:..
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 in any mm nor so as to violate the
/workmen's compensation laws of California.
\� �1_ytOe� Address .... -- - .....
Owner t ....... .....
�ZQ/ii�a-fi-'.. ... /l ----- -....Address -------------------------------------------------------------
form 280-1 782!Foft4fad Agent „oma Verde
RECORD OF INSPECTION
Foundation --------- e-- 6 4",f�
--------------------------------------------- Frame
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