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CITY OF SAN JOSE� BUILDING DEP TMENT
APPLICATION OR' �UlLDII4G PERMIT
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Date ---------------------------1 ..., 19----Permit�-2- ------------------
Application
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Application is hereby ma for a permit to ----- fL/ �.------------------------- ----------------------------
a ---------- Z...sfory,
---------------------------a-------Z...sfory, Type... �--- --- ./...1 L./-----------------------. Building
to be occupied only as ... _�%KJ. --..-r .:-C 9�� �
in accordance with Plans, Specifications and Plot -plan filed herewith.
Estimated Value of Improvements, $....M zo o.o--------------- >It -1
It
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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.
I certify that in the performance of the work for which this permit is issued I shall not employ any per.
son in any manner so as to violate the workmen's compensation laws of California.
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Owner.�✓ �tr�-/.0 �� -------... 4.-r.Address --------Ad-r- Q
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By...... /q— ��-----------------------------------------.Address ------------------------------------------------------------
cenlp3t4r4AR2 inbow R. W. Bri
form 280-I - gg5
RECORD OF INSPECTION
Foundation//le
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