28954 (2) 6637 . Clifford
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT 40z,
'Date---.......... --------- Permit No........ ----------
Application is hereby made for permit to ------/..... .................. --------I.......
------------------i-Building
a........ .....stor .......
'Y. Type----
at......j�D.(G,3
7 --------------------- ------
to
------------------ ----- -----------------------------------
/0.........
to be occupied only as.----..... . ..... ------------------------
in in accordance With Plans, Specifications s Pnd!pla filed
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 the construction, location, and use of buildings within the City of San Jose, will be complied with.
NISTA MANOR BUILDERS INC.
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Owner....----....... .................. Address 456.7...lk
............Adc1ress-.S'W.'L0A4/ (3�47Z�
,pp'o
By............49.A� —/�..... ...:............. -------------------
Contractor. Agent
Form 280-1
RECORD`OF INSPECTION
Foundation...... -/'--�'-, ---=f n ..--------...---.Fre ................................... 1. �
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Stucco -.............................................. -- ish..�:p
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