32986 (2) CIMdF SAN169k"64 BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date-. ----�- . ----------- 19-----C---V permit Nq.-..?0"7..4.x-._._...(
Application is hereby made for a- 'permit to ------(� --------- ------ .........I..............
5*Acry, yp 77' ...... Building
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to be occupied --
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in accordance with 'pecifico,/Wdl -pl h"th.
Estimated Value ve
Vo,enr ........
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 any manner so as to violate the workmen's compensation laws of California.
OwnerN0Q1.i-.Addressz///�!I:i6e&o
By -----Address ------------W'T---------------------------------
Form 280.1 cto
RECORD, OF INSPECTION
Foundation -- �{.�:�G�.��!✓/L4t•�- Frame /° - `' 1(✓�...' ±
5}ve.. . ---------------------------------------------------- Finish ._ }r�Q� f✓.. a.,!� `�"`..
3'7 03,r-