33108 CITY O�IiAN JOSE $66
6 BUILDING DEPARTMENT
APPLICATION FOR,"ILDING PERMIT
- 09
Date....... --------------........... 19_6a 5 7 Permit No. ...................
Application is hereby made for a permit to ---elrzln---------------------------------- ----------
------ --------------- Building
a.----------/.....story, Type____Z/..__ ------ ..........
at --- Zr
,�7e........01 ar--_ /��
to be occupied only as ----J. ------..----
-----------
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, $ �.39✓- C'6,---3----------)...........
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 nWomploy any per-
son in any enner so as to Afolate the workmen's compensation laws of California.
Owner ---–------ -----Address
;7------------------
--- ---- --- ------------------------
.....Address
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By ......e --tiff
Form 280-1 Con�1!4r, 2�2pge `C t
7'
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37 Ll