32986 (2) C E I�V66a ----BUILDING DEPARTMENT
17c OF SANI&i
APPLICATION FOR BUILDING PERMIT 0'5-
Dafe._;� ..� ......... 19 Permit No.-
Application
o.Application is hereby made for Zaer
mit To ------------------------------------------- ------------------------
4 -*Z----------------- Building
story, Type ----------------
'7-701VW,!!s a D -
)�A -- ---- ------
to be occupied only as 1-14Ld-ir4;4.
Vin accordance w ekcations)atNigan'LiedWerewith.
Estimated Value of Improvements, $__440Q-_.............
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-
,on in any manner so a, to violate the workman's compensation laws of California.
A
Owne ..!02)ry --------Add ress ------- -------�401f_ol
;��----------------------
Address -- ---- ........................
gent.;-------------------------------
Form 280-1
RECORD OF INSPECTION
Foundation Frame (
stl;&, ----- -------------------------------------------------------
Finish 77:o�i?---1-9..
- S2 a243
91