36881 (4)� X707 C'�'Y' 2
CITY OF SA JOSE L0_/_2� i?t.i'bJ K BUILDING DEPARTMENT
Q�APPLICATION FOR BUILDING PERMIT
Da+e (/1.: .... ------------------- 19-� Permit No: (Ul----------------------
Ap/plication is hereby made for a permit to ....:3V-L.4.D......----'................._.---_........
a.........1------story, Type--- '-"-'---/2 .5---------------------------- ----------- Building
at ---770 7------l-q e4 ... ... . ' W;r7 .
/_,
to be occupied only as ---
in accordance with Plans„ Specifica/ d Plltf n � r siX
Estimated Value of Improvements, $---vv��- 5- -----------------
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.
_..Address- /46,5
r�---------------Address _5 --------------------------------------------
Contr r, Agent -
Form 280-1
RECORD.' OF' INSPECTION
Foundation ...... 2, 'K,6
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Finish:_:
stuc
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