NO PERMIT NUMBER (oI 3 q Iz-. a.U6
r'ITMOW G DEPARTMENT
LOTI��APPLICATION FOR BUILDING PERMIT
Date--------8...Sept!.........................195.....59 Permit No,3-ea'o!!
Application is hereby made for a permit to------------biLLld..............................................................
a------_-9.40----0ory, Type-----------v------3oeidonCe-------------------------------------------------------------Building
Lot Noe l2 Fair rov �,3�?f an Josel Calif!
+ `q ---------------------------------------
one family dwells & garap
+o be occupied only as.....----------------------------------------------- -----------�-}-J---J-�.--�.......................-----------
in accordance with Plans, Specifications and Plo+-plan er�vMlf s/
S/a� � PLAN NOe
Estimated Value of Improvements, .. .f....... ..... .�------
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 com-
plied 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 as to become subject to the workmen's compensation laws of California.
EICR t OML'S. WC. 2001 a Camino :foal
Owner...-- - ... - Address.... - ........... - ............ --
Palo Alto! California
N A '`� `{IYF/Add-re-ss`..-_------------------------`-------------------.--
BY- --
Contractor, Agent
Form 380.1 A. L! SHA
RECORD OF INSPECTION
..... .------ ........... .. ... . .....
Foundation---------
...Fre
...
e-
Stucco---...------....... . FipA.. -------- ------------------- --
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