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CITY OF SAN JOSE BUILDING DEPARTMEN
APPLICATION FOR BUILDING PERMIT
Date..... ... ..........._....195X-- Permit .............
Application is hereby made for a permit to...8_4/-------------------------------------------a..--------- -......tory, Type_..:-_2z_7---------------- --------------------------------------------Building
at----------------- ......Itae....7./-------------- -(a.......
tobe occupied only as---------------------- ------------------------- ----7........ ----------------------
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 com-
plied with.
, certify that in the performance of the work for which this permit is issued I shall not'amploy any per-
son in any manner so as to ecom sub act Vol a workmen's compensation laws of California.
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- - - ----------Address----
Owner-- -------- 1�- --- -----.Address.....-... /1411 -------------
By------------ -----
Contractor. Agent
For. 280-1
RECORD OF INSPECTION
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Stucco........................ X,,-, --2
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