NO PERMIT NUMBER 928-30 Miller
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
1 ?. — 1 -.195. Permit No.............................---..........
Date----------------------•-•---------------
Application is hereby made for a permit to............. ..................................-----:-------
a......... .........story,Type---`--------`------.... - P�d! Building
I ...... ------
at---- —q -.. �Y�1 I.--I.. Y..... ...... ... ............... ........................ .
to be occupied only as-------- -.an - ..�..A G------------------- --- - --------- ------ ...-.....-....---
in a cordence with Plans, Specification`and Plot-plan filed.herewith.
tim fed Value of Improveme�I}s, ....
}h the �uir/nFen#s of.}he an Jos Bui in end ning r i antes e �al .tlheerlaws
It isob eg qPica et h co io loceti n, nd e uildin # C' ��Jpirit with.
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11xT---- -------
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BY-------------------------------------------- --------------- Address -......... - - -
Contrador/Apm#.
Form lW&Fi 928-30 Miller 2,_i8_S8� 0• Shoemake
RECORD OF INSPECTION
Foundafion_/Z_-3.!
....... '.-......LFreme.l.! -
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