37583 CITY OF SAN Jos BUILDING DEPARTMENT
APPLICATION,Fp
&.111,11ILDING PERMIT
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Date//z----------------------------- Pe mit t4o.3,7t�---Q-3-------------
Application
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Application is hereby made for 19 permit -------- ------------------------------------
......story, Type .. ..4---A ------------- Building
.... .... - ---- -------------
to be occupied only
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, $,4�0
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It is hereby agreed that the requirements of the San J 0 z8uildling 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-
so m any so
o
a to violate the workmen's compensation laws of Califr,
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---Address// ........—
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---........Address --- --------------------------_-----
C.
Form 280-1
RECORD OF INSPECTION - Q
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