35623 (2) 6A6% H1116
CI SAN J SE7- BUILDING DEPARTMENT
APPLICATIOI!,PR,B ING PERMIT
Date---- ---------------------------- 19---(0-e/ Permit No.---t1 3v�_3---
Application is hereby made for a permit to _Ojlo_�--------------------------------------------------_
a-------I---story, T e�.0 .......644R ----------- Building
at
.0t
to be occupied only, as .../..... .... ............ X167X
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, $---1-6,13-va..........
It is hereby agreed that the requirements of the San Jose 8iii1cling and Zoning Ordinances and all other
laws applicable to the construction, location, and use of buildings within the City of San Jose, will be
complied with.
I certify that in the performance of the work for which this permit is issued I shall not employ any per-
son in any manner so as to violate the workmen's compensation laws of California.
Owner ........Address
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By ---------/.'..Address -------
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2.0f�nlref&r, �X?Olrge Beard
Form 260�I Hills .
RECORD OF INSPECTION
Foundation ---- atvlr0- - -$IC
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Stucco ... ----- - -=' °c.G-_(- Finish
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