40931 11414;F SAN. JOSESunnyvale-Saratoga AOdd BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT elae
Tract No. Lot No. W/ q07�B
Date---------------------------------'r7... 1- ., 19_6..,7 Permit No._,40 r1 3 r�--------
Application is hereby made for ar.h —
permit to .....�.ia.I.: -----zh.l.�iJ �R- ------------------
a---------/..._story, Type.-=---/V`/- ------44.:r' - ......... ----... .- ---- Building
Use Zone ...__C_7:.f....
at ...1�25.. .. eC.'lct .. . . '� , Occupancy L .
to be occupied only as ... 'e.lfgldYLi.'h.... �j7 /y,�,J e ----------------------
in accordance with Plans, Specifications an P -plan fie herewith.
Estimated Value of Improvements, $__.. d00 ,
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 nner so as
to violate the workman's compensation lows of California.
� /'
Owner/ n. . AddresstF. .r.J.7�//J/11P -N�'t---G✓-�?-!'T
Bypq•ae: e"4:40 -�..'Address -- -----------------------------------------
-- _ - ... .
s_cti kel
Form
zeo-1 1655 Saratoga-Sunnyvale Rd. D. .S. .Schinkel
RECORD OF INSPECTION
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Stucco --------------------------------- --- - _ F' ish "-=--------��1
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