37597 CITY OF SAN JOSE /1,44' J BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
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Date .-. f." - ------------------------ 19.e<z Permit No.-3-74-f-,7-----------------
Application
o.-.3-75fes-,7-----------------
Application is herea"ade for a permit tom-G
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to be occupied only as,l 'fI
in accordance with Plans, Specifications and Plot-pled hrPlfAt
Estimated Value of improvements, $-/.. -
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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�manner so asst violate t workmen's compensation laws of Califor e
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By �� Address
Contractor; gent
Form 990-1 - - —
RECORD OF INSPECTION
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