31276 842 8telling1'�
CITY OF SAN JOSE 4f c* BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date------------- ------------- 19-4-4-7. Permit No... ...Q-2.6.............
Application is hereby made for permit to.. .... ---------------------------- ..........................
a-----------/.....story, Type_-—— ------------ ... ...........................Building
at ALI
.............. - ------ -------------------------
to be occupied only as......./J ---- . ..................
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, $.... -
..............
It is hereby agreed that the requirements of the-
It 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 com-
plied with.
I certify that in the performance of the work for which this permit is issued I shall not employ any par-
,on in t 6 b' t to the workmen's compensation laws of California.
0 ony so as.
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ByAddress........ .... ......#----------------------------------09.......
Cost,
Form 280%2 Stelling Loma Verde
RECORD OF INSPECTION
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