42420 7960 1700
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract No. ..... ......... Lot No.It.?---------
Date-ZO../--`�.............. ..................I 19 3' Permit No. ------------ --
U
is ........
hereby _Made for a permit .W�
S I ev�
a-- -------story, I ype ...... . .... .................. -- ----------------------I...... Building
Zone A-Ld---6------
at Occupancy ..........�p .......
to be occupied only as ----- -
Parking Space ----------i� .
---- ---------
in accordance with Plans, Specifications and Plof-planfiled herewith.
Estimated Value of Improvements. $ 5... .....1..._......•
It is hereby agreed that the requirements - ilding and Zoning Ord;na...s and all other
oc
laws applicable to the construction, lation, and use of buildings within the City of Son 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 workman's`compensation laws of California,
/C!�' ?
0 ...Address I ......... ... ..... ------ ... e4l�a... ........
Contracfo
---------- -;...............
..........Address - -- -- ---- -- - ------
Form 280.1
RECORD OF INSPECTION
✓
Foundation ---------------------- --------------------------- Frame
Stucco --- ------------- --
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