40898-7662 /�4fi,400111 Lane .
CITY OF SAN JOS CII BUILDING DEPARTMENT
APPLICATION FOR BUILDING T
Tract N.,?09J'L.1 N1.7 -- -----------
Date.-. ................................................... Permit No - ---- wo'r-_ff . . ........
Application is heree"6:aVdeor a permit .................. / ............ ------ -------
A
a.... ---/----story, �4- . ........ ..... ...✓.. _ ----- -- Building
--- - - ----//---at .74_21,44� . .................. Use Zone -------
Occu ancy
to be occupied only as Of - -------- - ---
.. .................... AIOFOVnF
';�V 7 — -----
in accordance with Plans, Specifications and Plof-plan fil . herewith.
Estimated Value of Improvements, ........ ... 1 ---------------
It
'). ...............
It is hereby agreed that the requirements of the Son 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 aso violate he workmen's compensation laws of Califo�7
Owner/x (� -57 /Z
r.............................. Address
Address --------- -- ---
Form 280-1
RECORD OF INSPECTION
Foundation---........................ me .5p.'.. ... - --------------- ---- ----
Mme
Stucco--- ---- ----------- -- - --------- ------------- -------- Finish ---
---- -----------
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