33664 101
CITY OF SAN JOSE BUILDING DEPARTMENT
AP"CAPON FOR BUILDING PERMIT:2,/9
aas�Date...../..> lq_��Cl.... Permit -------------
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Application is hereby made for/a permit to ----C.trs_�_ -----------------------------
a......./--------story, Type.......J7—___(- ., .... ....... ............
............. Building
at Aa ///P—
�?/ x/c
to be occupied only as ---&
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in accordance with Plans, Specifications ar61Vof-PlAileV1 We, �Jo
Estimated Value of improvements. $----- D.........?.....-.....
It -----------
6....
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 me I nner so as to violate the workmen's I compensation laws of, ...C/aNfornia,
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Owner .. .. ..... ..........Address ..
.. . ...
L.Address ---- ................................
d Contractor. nt
Form 280-111 1091 Stelling Linfield
RECORD OF INSPECTION
Foundation --------- ......................0,/A�..arne --------
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Stucco -------------------------- --------------------------------A<I-niS ------------
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