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CITY OF SAN JOSE �1N.K BUILDING DEPARTMENT
// APPLICATIO / BUILDING PERMIT
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Application is hereby msde for a permit to, AV - p
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to be occupied only as --
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in accordance with Plans, Specifications and Ian i herewi" +R5
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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 man r so a to viola the workmen's compensation laws of Califo
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Contractor, gent
Form 280-I _ -
RECORD OF INSPECTION
Foundation --------- ---
, 11--2-7 -61
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--------------------------- Frame
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Stucco
Finish ------------------------6- G 2Z }G� - V