804 879 Lily
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION Ff WING PERMIT Yom
Date-------------/ ------- ------..I 0... Permit No.........................................
Application is hereby me a for a permit to lev----------------------------------------------------
Building
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to be occupied only as.. {6 .._..............:..........`---------
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, $..../S.
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 this 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
in any m or so as to becom 's_ubj/ect to a work ens compensation ws of` Celiforna.
411: ddress..
Owner.:. - ---
By...::.---------- - ....... .....Address..........--------------------- ---------------- -- ...
Contractor, Agent
Form 2e0t79 Lily Loma Verde
RECORD OF INSPECTION
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Stucco................ ..._ — Finish -. ..y....P....G... a,�r
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