30504 877 Lonna
CITY OF SAN.JOSE BUILDING DEPARTMENT
APPLICATION FF R_�BU WING PERMIT �8y°3
- G
Date---
. zzl------------------ 19-. / 233Permit tAo..........
Application is hereby made for a Permit to----. ................... .....................
' a---------------story, Type--- ,... ..................... ..... .. .. .... uildi 9
at.- - - -- �C� HA2........ ........................`
to be occupied only --- -�+�"�
n 'ed re ith.
in accordance with P n , pacific (ions and PI p ,
Estimated Value of I provemen , $---/ . ..-.
It is hereby agreed t at the re ire n of e S n oso Building and Zoning Ordinances and all other
laws applicable to the onstruct' n, Iota ion, and use of buildings within the City of San Jose, will be com-
plied with.
I certify that in the mance of the work for hi h this permit is issued I shall not employ any per-
son in any nner so as to become subject to the we m n's compensation laws of California.
..� � ...gi p
Owne - A dress /� --
By- ! -. ..-. w `.'f......Address---------- ------------------------------------------------..-----
Contractor, Agent
Form 280.1 877 Lonna Loma Verde Const.
RECORD OF INSPECTION
Foundation.... -----Frame.._
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stucco...................-----------------------------------------------Finish----
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3 S-/ 9