42420 4i14490F SAN JoEe-n -In BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract Nor-:y.�- -----------
Lot No./--/............
Date..... ...... . ........................... 1 19 C�i Permit No._-4(-!n_4(k_0
4fication is hereby for a,, - ------ .........
i permit
plication 5;�e , I--- ---- ----
�lO�10 ..... . ..... --- ---- ----
a.......... Type.�4� ----------- Building
4story, ............
cum Use Zone RA.I.-A.....
Occupancy .........7::-------
Par(lrg"S'Paize ---------A911..........
to be occupied only as
in accordance with Plans, Specifications/and zz
Plof-plan filed her:A�t� -
Estimated Value of Improvements, $ ...0
It is hereby agreed that the requirements of the San Jose Building and Zoning Ordinance, and all other
laws applicable to the construction, location, and use of buildings within the city of Son 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 per-
son in any r a; t violate th workmen's s compensation laws Of California.
4A�_/e"2Address/*`5'z'.
Ow or --- - --
................ -------
Con ra for
By go .............C..Address
Form AO-1
RECORD OF INSPECTION
Foundation /O.c12-.�J._.'?� FFrame
Stucco --------__----------------------...--------------Y Finish-asr 104- 63
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