39960 C7 OF SAN BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract No,:r ZX_ Lot No. _49------------
Dat ......................... . 19----------
Permit No..
Application is hereby, ade for a permit {p�---- . .........................----------------
a-----/---------sf ry, Ty --------- - - - ---. . --
----------- Building
at .... ........... ....... Use Zone -----R.io-1- ------
ancy -------X-----------
Space IL
to be occupied only as - ------- ----- - -------- - "/4;?rk7, --------------
in accordance with Plans, Specifications and Plot-plan filed herewith.
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 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 an man er so a to iolate the/workmen's compensation laws of California.
�C,Aciclress
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Y nt,ac Address
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Form 280.1
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PECTION
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