NO PERMIT NUMBER CITY"O -SA N JOSE BUILDING DEPARTMENT.
L�1 1 _ APPLICATION FOR BUILDING PERMIT
Date....8. SCpt•............................195..59 Permit No.....
...............T
Application is hereby made for a permit to.........Uui].-d
a------ ae.....storyy, T/ype.--......---...: .:;_ic:i?;tcg.................................................................Building
'r /aT t'3it r OJ .;aa JO:rf" 1j.
at....+o t ..! Q.:...._.. .. �7 J���1 ....1.._=....... ..................
to be occupied only as------o e...;S.:L� i:Y..nu. tlj_R ;.. ?..1:.Kaco..-----._----------- ----
in accordance with Plans, Specifications an P fil e e!wlth.✓�
,['y .14 l\Vp
Estimated Value of Improvements, $/../-1 ---...
It is hereby agreed that the requirements of the Sen Jose Building and Zoning Ordinances and all other
laws applicable to the construction, location, and use of buildings within the City of Sen Jose, will be com-
plied with. s '
I certify that in the performance of the work for which this permit is issued I shall not employ any per-
son in any manner so es to become subject to the workmen's compensation laws of California.
: - 20C1 _;1 C hi7 no
•oat
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i'..--wn er_... It^ . ,. I:ICe---------....Address.........
.......................................
...............................^•.1-. 2jA
.. - ...._.... -Qr.:..-..- ..: ..............Address -
Contractor, Agent
Form 280.1 A. ins J4.11r:iJ "1�`-'','•`1--.-
i l iq RECORD OV INSPECTION'"''
F ......................................
. ...................----------------------------------- ------------
Stucco..................
...............—;....... .............Finish:,...w..... -------------------
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1, 1 �.T. -. .