46870 9�1 Mi112r r
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
= / > Tract No
:_ - -
..Lot No.............. ---- ---
Date............... /x-----3................... 19..`_ Permit No........- (D g- -0.........
Application is hereby made for.�a permit to --.......... -�......._7...J.......-
a------- ----story, TYPa---....----...-----.f ............. .. -------....... ....-----------... Building
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at - .... .....��... -... - --- -- -�-----. . . s n
( � c �c .........
to b 'Bd'0 as ------ -- Parking Space...------Z..-----..
in accordance with lans, Specifics+ions end Plot-plan filed herewith.
Estimated Value of Improvements, $........... -----------------
It is hereby agreed that the requirements of the San 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 person in
any manner so as to violate the workman's compensation laws of California.
Owner..R ..... -----------------Address.... / . '
Contractor
By Address �.7%`F
. �,�L
'•
_ ....
931 Miller Robert'Wade
RECORD OF INSPECTION
Foundation..............•-------....................... -- ---...Frame.------..--•--.........•-----........... -- - -
Stucco---..............--------
FOAM 280-1 -IOM-2/69