377977551 �quaro�d
CITY OF SAN JOSE C % ��� BUILDING DEPARTMENT
/ APPLICATION FOR BUILDING PERMIT
Date.. //. -------------------------- 19----------- Permit No. .3 7.71 ---- ---------- _
Application is hereby m e for a permit to F� ��
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OF
a.......... /---- story, Typpe _------: - - --- - ---- I--,--/ --------------------------------------- Building
at .:Sa.S� ., .�cvLP,Gu-D d W
to be occupied onl 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 manne so�as`to violate the workmen's compensation laws of Ca
liforn
Owne- ----"`f-"-'/%�!t�'.`> ddresz�%...12 `� .. �V. -------- ..
By(//� - 6 - -----------.Address . -� ------------------------------------
Contract gent
Form 280-1 - '�s
RECORD OF INSPECTION-
FoundatV12 Z
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