804 877 Lily
CITY OF SAN JOSE BUILDING DEPARTMENT
/APPLICATION_`
PPLICATION FOR BUILDING PERMIT S-0 jr—
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Date.............. -/.r------......I 96,0.- Permit No..------------------------------------
Application
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Application is hereby made for a�Zper it .............................................
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story, Type--- .........1 21,02- r -----------------------------Building
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to be occupied only as......?/ -----------------------------------------------
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements. $13_srL-�-
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.
I certify that in the performance of the work for which this permit is issued I shall not employ any per.
son in any al for to.
nn r s/ 0 donne bioct to the workmen's compensation laws of
------------Address.... .. ------- -
14. ................... .... G.
By........ ..................Address......... .......................
•
Contractor. Agent
Form 260-1 877 Lily V Lorna Verde
RECORD OF INSPECTION
Founo/lon Az�14��-o;vlv-------------------Frame.J.W�frqs;K.....
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Stucco..--------------------------------------...........
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