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CITY OF SAN JOSE -/ -BUILDING DEPARTMENT
APPLICATION FOR ' BUILDING PERMIT
Date---... ----... . ..--..............I95 f.. Per cruit No.-c3p.l..O.....6.,6----- -.........
Applicationis hereby made for a permit to_ ........................................................
a------ ....otory. Type--- ----------- ---------------------------------------Building
at-------------------------------JL .-.f.. ..................
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to be occupied only as.......... -----------------------------------------------------1�.Vic
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in accordance with Plans, Specifications and Plot-plan filed herewith.
Esfimafecl,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 com-
plied with.
, certify that in the performance of the work for which this permit is issued I shall not employ ani"per
son in any anner so as to become subject to the workman's compensation laws of California.
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Owner--- L_.'6LZ OXICT - Address--
By-----------------
.......Address------ ---144.1_pl�---- ---------
Contractor, Agent
Form 280-1
RECORD OF INSPECTION
Foundaf ion---- F
Stucco------------------
--------------------------------------------------Finish.... .........
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