35600 ji19 &y3
CITY OF SAN JOSE et.N _r ria„ c BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date...........V/G/61VIC/61.................. 19--`-�--- Permit No._;�?f..._.�a 42J:. _---------
Application is hereby made for a permit to ......g_.....`.......................
a-.... -i--------story,
, TYpe__z.......&V;r.&V;19;`ie ./1--- /v- ---------------------------- Building
at /�- /��
to be occupied only a1s .L_ !... _'.r......... �� '/ 5x
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, $---l...R.cs o c------------------
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.
�l certify that in the performance of the work far which this permit is issued I shell not employ any par-
son�fi any manner so as to violate the workmen's compensation laws of California.
Own, JZ J= 1,(y A -�-'Cryo_ < .+s. Address ._-.O..f..._`r9:..(�/r_w+y 9-----....
By �l Address w N SQJe ...
1
Contractor, Agent
Form 280-1
RECORD OF INSPECTION
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Foundation ...X-.,-- ----------------
Stucco Frame ----- -- ----
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751,
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