377977587
CITY OF SAN JOSE
f BUILDING DEPARTMENT
PLICATION FOR BUILDING PERMIT
Date ... //�A /
-----------------------------, Ig---------- Permit No...3-77y1---- ............
A..p.-lica+ion is hereby m de r a permit t/ ,.---------------------------------------------------
a-----/J-p----story, TYP/------------------------ Building
to be occupied only' as /.. ------7----- — v/
in accordance with Plans, Specifications and Plot -plan filed herewith.
/ ISS D
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 anne9 so as violate he workkmmmee�n'ss coom�pensation laws of Califor"a. �� �J
p -r 'GGf / -'`--v---"----- ddress / .(' S�l.`/// ..LV- ----
BY . -�'j -'x'12"--------------Address --------------------------------------
Contre - r, Agent
Form 280-1
RECORD OF INSPECTION
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