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4607803 bid TWhl . CITY OF SAN JOSE BUILDING DEPARTMENT APPLICATION FOR BUILDING PERMIT t ,/ Tract No.......................Lot No.......................... Ll `D 71S Date _2 ....-... !.......... 19.103. Permit No ............. ............................ Application is hereby made for a permit to ......... ............................................... a.........../-o'--o-3 --story, Type ----- 6�/ !jZ ..... Building -Z 3 D/q�. use Zone ...... )�..-'-�.---• a+ ..-..----- - -----....-----................W..z'f...--- � / Occupancy-•----- --------....... to be occupied only as (T—o . ...L.e., l .-. �r�-� a �y/P king' -Spacer ....................... in accordance with Plans, Specifications andePlot-plan filad0herewith. v%L' Estimated Value of Improvements, $......... AQ7:1-0 ............... 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. 11 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 w rkmen's co ensation laws of California. ep, Owner..Lti>�... ........ Address --D ........ . Z By Agent: .....:y`' s_cid_cic.Ad clress./.�!!..= -------- ..... Alkd OWPC �/� G/� '�?T�rry Kani RECORD OF INSPECTION Form I80-I—IOM-13-63 '®