33364 912 R6,§O 1316s60M
CITY OF SAN JOSE /—o-r v j BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT 5-0 '(-
Date........ ..../--Q-------------------------- I g.'e."ei-C? Permit No.------- ...3.... ..t(e------
Application is hereby made for a permit to ... -------------------------------------------------
a.---------/......story, Type.. ------ ............... Building
ISI
at -----I./.2.........24)5_�......5-9:_&
to be occupied only as .../---r,40.1--i........
in accordance with Plans, Specifications and Plot-plan filed herewith.'
Estimated Value of Improvements, $...... -_Q........
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 nor r as to violate the workman's compensation laws of California.
Owner
. .. .......Aciclress<,�.�_ S-f42e
--- -- ----- . ...... .....
By ---- -- - - ------------Address ......
Contractor. Agent
Form 280-1
RECO RD OF INSPECTION
Foundation --------
----------------------------------------------- Frame
Stucco ---------------------- -------------------------- -------
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