43212 (2) BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract No � Lot No. -------
Dot e 19C�5 -3 Permit No.
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Application is hereb d for a permit
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a.------/-.story, T ........ -PSI----- --------------------------__ ...... -------------........ Building
atUse ne ----------
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c ncy - --------
to be occupied only as . Ing Space Vic..._-_......
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in accordance with Pla s, Specifica ions d t- rewith.
Estimated Value oof Im roveme , - --- ------- -- -------L............
ed
It is hereby ogre a requ ements o t r ose Building and Zoning Ordinances and all other
that
laws applicable to the const
st locatio ,at n use
. buildings within the City of San Jose, will be
complied with.
I certify that in the performance of the o r wh this permit is issued I shall not employ any per-
son in any manner s a,
t .ooa I t the on wor n's compons,ti,n law, of Califo�ia.
7Address ---- - ---------- ... ----------
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Bcon .Address --- --- --------- ---
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Form 280-1
/RECORD OF INSPECTION
Foundation ... ---. Frame ...
Stucco ................---- —------------------
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