32009 _CLT.Y_(d_tA�SE— BUILDING-DEPARTMENT
LOT.I.APPLICATION FOR BUILDING PERMIT
Date------8..Zept.n---........-........---' 19...55...55_ Permit No..I
................ ................
Application is hereby made for a permit to..........bu:Lld--------------------------------------------------
a....... story, Type......__$--.... .... .... ........................................Building
ous-----
at------1,ot--- 1`=rgravz__=...Tr_azt.110.o.._2,533.s..
... . ...
to be occupied only as........ane...f emUy---dWC4oXEk,- .. ........
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, $,/ ........... PLAN NO.
It is hereby agreed that the requirements of the San Jose Building and Zoning Ordinances and all other
jaws applicable to the construction, location, and use of buildings within the City of San Jose, will be com.
plied with.
, 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 become subject to the workmen's compensation laws of California.
Owner-------&1_GJ14,ZR---1IQX1;za---IDN--.----........Address........2001...'A--_(;_-�trA.nQ_JRQ .......
Address.........Pa1O--A1-tO-i,--.Q-Q11fQrAia
By --
280.-I... Antra tor, gen} \�
Farm o
A, Le SH;-p
RECORD OF INSPECTION
Foundation L' .. -/G - _-%...'.....S....�....p-.L.-........-FC,�
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S+ucco....--------......... -------------
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