32339 CITY OvSAN_jd!�Ir
BUILDING DEPARTMENT
1OT_/�E_APPLICATION FOR BUILDING PERMIT
DEC.2 3 .
Date - 195......a� Permit No..
Application is hereby made for a permit to.._..._....'�Li. ....................................................
a.........V:1C._story, Type.............v----------- lt+::-1tCe---------------------------------------------------------....Building
to be occupied only as.......... nF. ..Jn-y at_ei21n.:.-u. r'�rol'.e ---_----------------
in accordance with Plans, Specificatio$-- 1n`s nd Plo+ p an!iled rewlth. /
Q0O —
Estimated Value of Improvements, --. ....
Itis hereby agreed that the requirements of the San Joie 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.
I certify that in the performance of the work for which this permit is issued Ishell not employ any per
-
son in any manner so es to become subject to the workmen's compensation laws of California. _
.:rr ; . 3;: .
.- - --------------------------.�
Owner------- -- ........Address
'.'^.... .....o�.----..
:.' -- ..ii... - ......_w
�\ l -- i0--s......
4 _ Vie::' '' .:.............Address '-'-- -------------- -. -
Contractor, Agent %
Form 280.1 \ u . .�t. .l':(CJ
RECORD OFINSPECTION/
FounWrion--- ................. 4.......IZ4 �in,?- 11 1
>Hfire ................... --------
5+ o
.......................Finish----- -.: 4—ko
----------------------------------------- ... .... ...
tit k4 I'