41949 � �q Milky Way . t
1TY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract No. .................... Lot No. .................
.....:....... -- , 19--- Permit No. -4--------------- ---------------�w --
--------
,
Application is hereby made for, a permit to ...1.J.. ......... ..
a.....- - ----story, Type--- - - -- --- �. .._ - - -.. .----- Building
1 ---------- -------------- ildi
9 Use Zone ........2-�...
at ......... .10V....1u.16 .. .....L✓d 7
1 p �� �y my ..... . . ......
to be occupied only as --- ..2> :.._....��.... .. r ng Space ......_L...._._...
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, $....3go-o
It is hereby agreed that the requirements of the Son 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 to violate the workmen's compensation laws of California.
Owner /� /yr- /�F « t //09 lyfA- . y Sir- - ... - - J ... .%...r............QS.. -----Address
Contractor PSP E. Eh.--(r,.,,�.,,o.. ... s��n ..vol
ByAwaf-----
--- /G¢ OVPH.... U�s---..hY................Address >
Form 280-11109 Milkv 'S Mr. '& Mrs. J. F. Chase
RECORD
OF INSPECTION
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Stucco ------------------ -- ----------------------------------------- Finish
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