38477 (2) CIOU SAN JOSE 611�tlbi�8 bfthJ6 BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract No- -------------------- Lot No- --------------------
Date----------------?----/?---------------------- Permit No.,3-§A)
...............
Application is ,2
herebb made for a permit .........
TYP
a- ON-C----story, a ... .... 0--------- --------------------------- Building
Use Zone ...lc-./-----------
at ---------------- Occupancy ......r------------
to be occupied only as 19 --- --- - -- ---& -%—
d P?0"IqV.ng'Space ----------------------
%Of —
in accoidanc"e with Plans, Specificaz Ian filed her/with.
Estimated Value of Improvements, $----
It 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 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 s, to violate the work compensation low, of California
Owner --------Address ..........
contract i
ByAgent----------------------------- ----------------- ----I------- Addr'ess ------------------------------ ---------- --------- -
Form 280-1 6595 Clifford Dr. Thofr,:-i,-, J. I-T-)l rr Z-6 '9 3
RECORD OF INSPECTION
Foundation
-------------------- Frame -------_-._-----.--------------------------.
Stucco
---------- ------------------------------Stucco ..................................- --------- Finish ...........
o is 5 /C -C,
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