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84 OF SAN JOSE ` BUILDING DEPARTMENT
A�-
APPLICATION FOR
FOR BUILDING PERMIT
Date— ----------------------I 19c,�-v Permit No—T—
is hereby Made for a permit to �--- -----------------------------------a------/--------story, Typj��-. ZA46 Building
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to be occupied only al.—.Za�.... .6
in accordance with Plans, Specifications and Plot-plan/filed hrew'
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 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 as to violate the workman's compensation laws Of C I'f
a,
"To
Ow4n.r -.�TAciclresv/
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........Address/r1... /(----------------------------------------------
B , 15�- / I
Contractor, gent
Form 280-1
RECORD OF INSPECTION
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Sfucco ------------------------------ -`--------- Finis
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