49913 FRECORD OF INSPECTION
• FORM 280-1 -IOM-2/65
6021 Sha.dygrove
CITY OF SAN JOSE SUMDONG DEPARMENT
APPLOCATION FOR RUPWOMG PERMIT 4
Tract No.. -'----....... Lot No.---..............
Date---- ............. . 2- ................... I Permit
/_ C�
ermit to ------- : ...............
Application is hereby made for ----------------- . ..... -------
072 Building
. .. .....................
a ........ ........ story. Type ------------
Use Zone .....
Z-rz/
at ---- ------- CCU on- ------- ---------
S-.7 0-
7'-' - - _-------------_-
be as // 14 1
to occupied only --- --- . ..
'P
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
location, and use of buildings within the City of San Jose, will be complied with.
applicable to the construction,
I certify that in the performance of the work for which this permit is issued I shall not employ any person in
any manner so as to violate the workman's compensation laws of California.
Owner ...... . ........... Address -------
Contractor%
............ ---------- --------
ByAgent.._ ........ ...................... ---.Address.
6021 Shadygrove W. J. Conner
RECORD OF INSPECTION
• FORM 280-1 -IOM-2/65
6021 Shadygrove
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT IU4
Tract No ......................Lot No ....... ..................
Date ................... i ................. .. Permit No.... z --- 3 ......
Application is hereby made for ermit to .-.-.--11.0 rl ............ t! ................................
Building
a.......1 --------story, Type ........... & ..... _---------------
a+ Use Zone.fFLe:::1'--
only as ... cu ...... ...........
to be occupied on .......... 10 cu . .....................
.:�6 elyl�_
in accordance with Plans, Specifications and Plot -plan filed herewith.
Estimated Value of Improvements, $......... QE02D
................
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 buildingswithin 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 person in
any manner so as to violate the workman's compensation laws of California.
Owner .... 9.h.:sr.'.
........... Address ... ......
Contractor 6�)re2;P7/0-r
ByAgent ................... .. .. .................................... Address ..................................................................
6021 Shadygrove W. J. Conner
RECORD OF INSPECTION
F--- 280-1-10.-2/65