32339 997 w. C6�
CITY OF SAN JOSE " .BUILDING DEPARTMENT
LOTJ_L.�__APPLICATION FOR BUILDING PERMIT
.33.EDate.._.... �<...DEC:2:..........195.....x% Permit No. -' -
Application is hereby made for a permit to............btt :ci
..............................................................
a--------- --story, Type-----.....'-......C:::..J :CC .............-................----'-------....---.........Building
:10 ^ ..:.. r' isS
at.......Lot... ' ...j.}3.....'" r_.r, ... .=- y-:..._• :: :
to be occupied only as.......... nr'..::•''tti./_-<ittC.l.�i.n_,_-- :i'.a;^,C-_
in accordance with Plans, Specificafion/s an/d/Pl//o/f•plen f4e� a rvFtW'W00 v'/may/`%)_,' ([/
Estimated Value of Improvements, ... .. .. ...
It is 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 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 per-
son in any manner so as to become subject to the workmen's compensation laws of California.
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. L. .:...a-' '- ...Address..
Contractor. Agent
Fern, 280-I 1 u ,+ .I'.�Q '�`••. '� —\—
RECORD OF INSPECTIgN
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