39653 (2) BAi h& RU..
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDINGfERMIT
Tract No. Lot No. -- -----
---- CIO Permit No. .......
- ---- ----- --- -----------
Date-.,----- ------ ------1 7- -
Application is herpo a a m'f
�y -------------------- ------ ------- - --------------
10 rpa
p --------- Building
----------- ......fory, TYPe "- - - 4 .... ... .. .. ----------
/M�"XX 'eej Use Zone ---:`r-----------
at ---
Occupancy - ------
Parking Space ..--------------------
to be occupied only as --- jl--�15 -----
I , P4
in accordance with Plans, Specifi i Ila�, L$-,it h.
Estimated' Value of Improvements, $..-...;-1-49 11 VC 4n...
7........... ----
if is hereby agreed that the requirements of the Son Jose Building and Zoning Ordinances and all other
laws applicable to the construction, location, and use of buildings within the Cify:.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 m as to violate the workmen's compensation laws of California. -r,'
Owner-�I'Y,za .........-Address
contractor
BYA9.0-a&Z ...... .. ..... .. .. Address. Y, ze'Lj�-�. �
Form 280-i 6325-27 B611in er Rd. Gerald) Oakley
RECORD OF INSPECTION n
Foundation - -- - ..y
Stucco .
! ...._. .
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