30504 861 t6tna
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Permit No..........
Date.....-/-....----------17...................................... Iq,__,""`/ . ........
ica !on 'i *f f
A I' f* s hereby 'ma a PWm1 0---- ... ..... ............... --------------------
........ uilding
a--------7------story, Typ .91, --- ---------------- ......
at----------------aa.. ........ -- --- .....'*?...... ------- -- --- ... . .... -- - - ----- ----- ..........
to be occupied on ------/.........- ...... Wit.---
in
-- --- .....
in accordance wit Plans, Spa ificaf io d Plo pla it herewith.
Estimated Value of Improve ts. -------------
It
------------
It is hereby agreed hat the r u a ants of h San Jose Building and Zoning Ordinances and all other
laws applicable to the onsirucfi n, location, an so of buildings within the City of San Jose, will be corn•
plied with.
I certify that in the is rfor ante of the work f which this permit is issued I shall not employ any per-
son in any anner so as to come sublo to the Amen's compensation laws of California.
Owner .. .. . ........
.. .. .. ... .. .. .......\.....
By-------- ......... .... . . .........Address. - - - `----................................... ...
Con
.Address- -- -----
----------------------------------------- ---
Con rector, Agent
Form 280.1
861 Lonna Loma Verde
RECORD OF INSPECTION
Foundation-- � .. f �C��n 1� rame..._lb�..2. /""`lam
li
Stucco
oundation---
Stucco.........................
----------------------------------------Finish_... ------