34501 ;r q1TY T i 1 E,4T v �
C v SAN JOS BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
/
Date/o/-
ate o/- o . 3 T
-- -.. ........ .. ... . 19.�..--- Permit No.--- ...---� - - ...-- ---
Ap//plication is hereby-,made for a permit to ..................................................'
a--------/------story, Type,.-k/- . %�� .:.-----`--------------- ------....------------------------------ Building
to be occupied only as �-j//a /��
in accordance with Plans, Specifications and Plot-pl d here
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 which this permit is issued I shall not employ any per-
son in an am r so s to violate the workman's compensation laws/of s�Calif�nia. /
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Addres
---.Address --Q
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Cont, or.
Agent
Form 2B0-I
RECORD INSPECTION
Foundation -----le ,-v ei-`OFAe ,
------------------------------------------------ Frame
Stucco
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