42664 7779 Robit1d21Y Way
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract No.AX5�1----- Lot No. ......
Date..../0.:n-!Y.............................. ... . 19-0.. Permit ............
Application is hereby made for a permit foae&v......................................................
a....-. -------story, Type-- t x--tv_ Building
use one ......R.-/------
cupancy ...T................
to be occupied only as --- // f "�arking Space ------------------
- -------------- - .... ..
in accordance with Plans, Specifications and Plof-plan filed herewith.
Estimated Value of Improvements, $-/.000.--' .................
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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 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 manner so to violate the workmen's compensation laws of California.
Owner Address 7*779-R08iryDFQ1-L---UAVJ,-COPT
Contractor
ByAq-nt..--------------------- - ---------------------------: ._.....Address ..........----....------------------......-----
Form
------------------------------- ---------- ---------Form 280-1 7779 Robindell Way Marlin J. CDokman
RECORD OF INSPECTION
Foundation
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Stucco -----------
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