36881 (3) K
BUILDING DEPARTMENT
Aik
X707-IIOAFFIISAA JOSE 7?'I P-4-
APPLICATION FOR BUILDING PERMIT
19.-�_ Permit No-RIA- --------------------_---
Date--- �_4 1
�P_ /------------------ 'a ----
Application is hereby made for. a permit to -----I ------------------------------------------
----------L.....story, Type... ------------------------0---------------------- ---------------- Building
at --7-7.07_.-.-i_ l
to be occupied only
in accordance with Plans, Specii ica d
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 As 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.
- 1J_- j .1- ... _,,_ZV6r_ - -
Ownerk�-..�T -IL C.- R../2 S. C'Z" ...Address 1,46
.... -------------- ---------------------
B I Mj! --------.Address
ConfrqEW. Agent
Form 280-1