43026-F 6224 Shady GroVO
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract No. ZT2 .......... Lot No- -----.77G......
Date-------------- --------- t�j o UP -F
----------- -- 19---6.1 Permit No_-.. ......................
Application is hereby made for a permit to .....5o------ - -----.......................
a....----.......story, Type-------- ------------------------ Building
at ....6_114 I!tprol----4Rom( --Dt?0q� Use Zone ----- --------
' n
pp
el.�::---------
to be occupied only as ----ftQ_(_v._jP0!.P0 a
---- --------
in accordance with Plans, Specifications and Plot-plan filed herewith. :5 Fe L er7rA
L�F
Estimated Value of Improvements, $---- .................... XnM L�/_
It is hereby agreed that the requirements of the San Jose Building and Zoning Ordinances 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 perfcrmance of the work 'for which this permit is issued I shall not employ any per-
son in any manner so as to violate the workmen's compensation laws of Colifcrnia.
Owner 1,--,4
.... 0v a ov - ----- ---Add
Address 4221e.
......4.
z
contractor & eBYA .nt.. ... I- - --- - V .... 0 ...JAddress
Form 280-1 6224 Shady GrOX70 MDnrir-v
RECORD OF INSPECTION
Foundation G_3..... -Frame
Stucco ----"-----------'-------------------------.._.. Finish ...X.-�