37597 �R OF SAN JOSE�t � r
/ fv� UICANGt EPARTMENT
APPLICATION FOR BUILDING PERMIT
Date-
/
Permit No...3.7ti�y2------------------
Application is hereb ade fyr a permit to .....................
a._------./_...story, Ty e----------------------...__ r �.......---............ Building
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to be occupied only as .`-. '� .'- �� .p�J//y/�
in accordance with Plans, Specifications and Plot-plan fd d herewi
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 shall not employ any per-
son in any man ar so s to v'I to the workmen's compensation laws of Califorpig C
` ----Address�Ow l�` .. ,— /! 7-
By
BY ---------Addres # /
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Contracfor, A ant
porm 280-1 -- - -
RECORD OF INSPECTION
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