48115 1032 November
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
)Tract No...... .... .. -
Lot No.................:.... / 7
Date""""............. A '`............... 19""---.... Permit No.........................................
Application is hereby made for a.permit to .....A,15Z........ .:�-........
a.......f'--....st Type-----.......... ......LL .. .... Building
at ............. �j�IOpD Use Zone..�'-�---�-.
Y�4"IV �ocupancy--------'..------'----
to be occupied only as ..---,!....7.............. _. king .....7,
in accordance with Plans. Specifications andfPl to 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 workmen's compensation laws of California.
// 7
Owner.' - .......................Address..ZZ23. ......_AOi� !r P�!.... it:....
Contracto
ByAgen+.lQlt/L ? address - .............
Pan
,.,� rac
1032"-N"oveember g
A
RECORD OF INSPECTION
Foundation----...................................-------------------Frame
Sfucco..................................................................Finish-,
(J----------------------------- -...
FORM 280-1 -10M-2/85