31081 (2) 885 BldilAgw6 0 6
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
7- Permit No...r ------------------
Date---------------- _-�/------ .........195.T
Application is hereby made for a permit to......-4,�
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a............./---story, Type_ -------- V. ... -------------------------....Building
at............................................. .... ... ................ ..................----------------------------..............................
to be occupied only as1�1 —/ m -
... . ......... .. ..... . -ooc------4�ft,
-------------------------------- ....................................
in accordance with Pla 1 cation ith.
Estimated Value of I rove ents, $------- -- ---------------------
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 com.
phed'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 compensa!ion laws of California., I
Owner_ atle,,,�..C -suy_ .1 -.Addresi......ll.112-.El---Camino---Way-----------------
W�p
-.Address...--P.ai-Q---Alt.Q---------------------------------------
for, Agent
Form 290.1885' Blazing d Wheatley
RECORD OF INSPECTION
'2
Foundation........../-.�................e.............................Frarne:.2...q-- 07 RA�
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Stucco--------._........................................
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