38563 7542 1 �Qe f 0 fA -hurt
CITY OF SAN JOSE 1911141 j C'� BUILDING DEPARTMENT
// APPLICATION FOR. BUILDING PERMITlR - g 9 9
Date�----L...o, - ----------- 19---------. ermit3No- -_�5�----3--------
Applicafion is hereby_made.fgr a permit to .......... _.... ...r..--_........._._......._....._.......
a ---->-------.story, TYpe� - ... ._/C/G� Building
--- ---- ..............................
/7 ,�/
to be occupied only as/Z--/ --------- -----
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, $.��t-5 -.e�_ .*
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
complied 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 manner so as o violate the workman's compensation laws of Califorrnl.
0 r -- � ��� ... --.....Address
By
�- Address
Contractor, ant
Form 280-1 - -
RECORD OF INSPECTION
Foundation --------------------------------------Y-6 '6 IF
----------------- ram --- ---------------------------
��o f F ---------------------------------
Li
ishfacto ----------------------------------------------------------- ---Zinis 5�
h -------------------------