42420 GWOF SAN Agnin]I. -,Ln/��_ BUILDING DEPARTMENT
APPL=CATION FOR BUILDING PERMIT
Tract No.a_4/ �'1' Lot No. Z 5-------
Date----- .. .................................. 19.K3 Permit No...I/
Z ---------
Application is hereby� e for a permit to�,�_ ------------------------------------------------------------
a -,--- story. Type
----------------------- Building
at Use Zone jkjl_�------
lf��..7 �.,Odcupancy ------7------------
to be occupied only as
)M/APairCing_A;ace ......... -----------
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 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 perfcrmance of the work for which this permit is issued I shall not employ any per
son in �an y as violate the workmen's compensation laws of California.
any �o Address��.-��Zzj� --------------
.7or
a�Ior -------------Address .........
ByAgiint-
Form 280.1
RECORD OF INSPECTION
Foundation --- .................
----------- Frame --- --- - ---------- ..................................
Stucco --------------------------------------------------------
Finish
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