34806 (2) 6552 CLiEfbi4d Cti I
CITY OF SAN JOSE GoT- /20 BUILDING DEPARTMENT
NT
R BUILDING PERMIT
_
14 20
Data:.I/-12---------`-...-......-......-- 19.6�1... Permit No....._.-?-���6.---....
Application is hereby made„for a ppermit to....../UYV; ,-� �..Qf..
a----orce-------story,`Type....... e '- ^v� P � �WMe7:4:itCc........Building
�. _P,---CSA---1Lo _tea%---20�7jA--V �....
to be occupied only as..Q-. �. r -------------------- -------......................
in accordance with Pla S I erewith.
i
'Estimated Value of Improvemen $./� ����......_....
It is hereby agreed that the requiremen a San g oo Ordinances and all other
laws applicable to the construction, lac use odMfTi_ !y of San Jose, will be com-
plied with. //////
1 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 become subject to the workmen's compensation laws of California.
Own yr..1,Ca--.c�..�.u-fi7..fe.-- . f:XfJ deA..........Address--^-��--------------�------------- _....�..
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Address. ---------
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Form l N a Sco;&La - Sa o.Je
E Ct. exan:ler
RECORD OF INSPECTION n
Founda+ion--l�
Stucco....................................----•-••----....-..�r......Finish-:::.....
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