35938 6211
ITY OF SAN JOSE z BUILDING DEf,,ARTMENT
APPLICATION FOR BUILDING PERMIT�.C�,.,j
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Data-... lt�_,59,........... 19---- Permit No._j1_5_9j?..............
Application is hereVb6 mefor a permit to --------------------------------------
a------ ..........f,ry, ----- ------4 ----------------------- Building
I I I
at -------------4-R11_--------------
A!�
to be occupied only as -------------
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 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 as to violate the workman's compensation laws of California.
Li;,o;uf rlvlflc,, 611C.
Owner ----------ML-St_.Ff3P4s--D4v4a-------------------Address ---------------- ---------------------------------------------
.... ....../ko la
Ca..`..iyia ----------------------------------------
- -----.,Address ------------------------
By
Contractor, Agent
Form 280-1
RECORD OF INSPECTION
Found ----------------_-----------------.---.-_-_--r-
FrairneA---
Stucco
Fin. �F