33751 JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING -PERMIT
Date--------7, 11----------- .......... Ig...ti�t-.Q .Permit No.-----/-3.7.5. /--------
I
Application is hereby made for a permit to ------ d.-----.-.Y o.r...........
a----------/-,story, Type Z, ...... ------A_P.xvi------//-7P,(& Building
at --- ---3 �-Q------- ... ... 'PAP,
Pd-,
to be occupied only 6!a i
1 in accordance with Plans, Specifications o0f-
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 yhich this permit is issued I shall not er6pl6y any per-
son in any manner so as
to violate the workman's compensation laws of California,,
Owner .(qld)fl Address ------------- ---------
----------- ---*----------
By ... ......X�..AWress�.�/---
Form 280-1 3 51jon1ragtj,,jgf I,,, W. Cox
RECORD OF INSPECTION'
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