27781 866=68 Miller
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATIONFOR BUILDING PERMIT L� /
Date---------------- .-------1951L�. .p��. Permit No.------/ ,�....!....(............ .
Application is hereby mad ,fora permit to....../ may!^----------------------------------------------------------
a--�------ --. . story, Type.:r_1 .......l.Ly�_44�5.... ----------------Building
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to.be occupied only as----- f'�--------------------------------- ......-----------------...----------------
in aor nce with Plans, S ecificafionss�aannd .p filed h wifh.
Es{im fed nt T \r�
It is hereby agree het the requiem of the Sen Jose Building and Zoning Ordinances and all other laws `
applicable to the cons ruction, location, and use of buildings within the City of Sen Jose, will be complied with.
-. p � Address.... /- --`- 1 / ✓" �'�
Owner.... ----�-- �h„ � .... - s'[ �- ---------------------------
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r ....... Address -
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Contractor, Agent
Form 2BD-1 866-b8 Miller 0 . F. Shoemake
RECORD OF INSPECTION
Foundafion,-4.:�- peiWA...................Frarne.---5-.9-'s b" " .
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