42420 PerE
CITY O7 F SAN SJO �K
CL,%47 BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract Lot No/ ._...........
Date_ 19 1:/I Parr it No..,
....................................... ---------- ytl ............
Application is hereby made for, a permi f 6 ----------------- ......
a....._- -----stor W_
Y. ..... .... . .... ................................. Building-
at ... -----//y.,----- Use Zol..
0 1 !.. .....1:.........
to be occupied only a--.- ------------------ --------- P/ in JSpace ---------
0 W9
in accordance with Plans. Specifications and Plof-plan filed herewith.
Estimated Value of Improvements, ------- -
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'.41h. L
per-
soncertify that in the performance of the work for which this permit is issued I shall not employ any or-
son in any man er so as violate he workmen's compensation laws of Calijf�onia.,
-'r-CAddl rlo..............
0L` .. ....
............. ............. ...
ByAge 1 -------Adclressl�
Form 280-1
RECORD
OF INSPECTION
Foundation ---L.O. �."C3_ti(NIJ._.,/Frame
stucco . ---------- :--- -------------- Finish
fl3
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