37542 7941 October
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FPR BUILDING PERMIT
7 N 13
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Application is hereby made for a ermit to .- �'-`---rt/ � --------7-------------------
a.
-------- Building
a.---------I......story, Typo----- -----, ------------------------------------------------------------------- 9
to be occupied only as O.A. ti4a--, ii
in accordance with Plans, Specifica#ions.eed,�Plot-plan filed herewith.
Estimated Value of Improvements, $.... ° C-�.'��- /00;0
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. = '
I certify that in the performance of the work for which this permit is issued I shall not employ any per.
son in any
ymanner
�so as to violate the workman's compensation flaws of California.
Ownerc- t_-Lr.. / -`JE/K --------...... CII �``'�
Address .-..-. ....
X. __� r - ------�------------- --
By !G. ... ---'- - Address -- -
f Contract. , Agent
Form 280.1 - --
RECORD _ OF INSPECTION
Foundation 7120_�� Z .4�-�F�am9 ---- --- -- ---Git_(��o
Stucco ,.,,-. �.ftrLriS.:.�-�-�c--� �Lr/