36160 CITY0i4 SW JOSE d °?� R15� ZBUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date-------------�c------------------------- 19.6x1-../--- Permit No.---:6,n '
Application is hereby made for a permit to .-9!� ----------.----------------------------------------------
a-'--'--/-'----zforY, Type----�---- '--"-"----'------------------------ Building
at --- ....--Do .
to be occupied only as -.. .%?1...---....
in accordance with Plans, Specifications an eeA
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 with.
I certify that in the performance of the work for which this permit is issued I shell not employ any per.
son in anymannersoca as to violate the workman's compensation laws of California.
Owner � v L(-oJo ... ...Address
By .. .r.�, ctc ...-- ......Address G ti u.S.�......'-"-. . . .........
Cnlr, , Agent
Form 280.1
RECORD OF INSPECTION
Foundation
..........
Stucco
71 Y.. ---- Finish g.-......
(0 -7