42815 T 118
WOF SAN Affrd 1�1 BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract No: 7 V!y. ..... Lot No,;?_.�...
Dat,/o//7-------------------- ......... 19........1�7 Pon# -------------------
Application is hereb d for permit to��"..... ---------
a----------L.story, ---------------------- Building
Use Zone
---------- ------------ ------- . 1�
0 c ii a6c -)_..`1-c....-----.
'.Ir-------------
to be occupied only as /PPUcn;gQpra,r, (_-`1-c---------
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements. $_/
If is hereby agreed that the requirements of the San Jose 9uilding and Zoning Ordinances and all other
lows 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
issued
Is1A not employ any per-
son violet the work en's compensation laws of California
0'y ------------
...
n ----Address/° l .... ....
C
at
8;A ....Address, �/--------------- --- ------
Form 280.1
RECORD OF INSPECTION
Foundation ,-1-I--- -"-- ...... ...............
-------- Frame
Stucco -------- ------ ..................... ------------- -/Finish .,v
.................
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