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CITY OF SAN JOSE /L BUILDING DEPARTMENT
A PLICATION FOR BUILDING PERMIT
r Date........A117" P C5
.............. _195...9-1 ermil No._&a.0_6...................
• Application is hereby made for a permit o._,91z.:/-------------....................................
a story, Type... .... ------------ ...........................---.....--------------.Build'
........................Building
4;- ------- ---------- ;z 24,�c
tobe occupied only as---- ...... (--'- 10(1�_ ------------------------_-----------------------------------------------
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 earn-
plied with.
, certify that in the performance of the work for which this permit is issued I shall nof employ any per-
son in any an�ar.so to b ome s blec the workmen's compensation laws efZalifi2.
74Address....P1—------ .4
Owne
Address...........441
,__p
By---------- - ---------Add ................. .. ....
Contractor. Agent
Form 280.1
RECORD OF INSPECTPN
Foundation.........
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sw�cco
-------------------Finish.....