43123 (2) 1050066666 'i�V D
CITY OF SAN JOSE' �/ ���y� BUILDING DEPARTMENT
APPLICATION FOR BUILDING ERMIT
Tract Lot No
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Date.. `� _...`5--- - - .. .... ... 19Sa//... Permit No.. - '------------------------------
Application,
- .._..... ='Applica#ion is here"b ad�or a permit fom...__���.__........_.._------..._._.__.....__.
//iy P.�✓ Buildin
a----- / story, Type -. .� ... --.------- ......._....... .----------...._ .. 9
f ...... y. YP
at
/d SC .... '� �.� se Zone ---%z.(..r..j:6-
- Occupancy .......... ----------
to be occupied only a . ...'�....__------ ----- Parking Space ..........Z—...
in accordance with la , Spec is s n Plot-plan filed herewith.
Estimated Value of Improve e $ ...5_.-.C..Q..-�........
It is hereby agreed th t the r uirements f th San Jose Building and Zoning Ordinances and all other
laws applicable to the c nstru or, location, and use of buildings within the City of San Jose, will 6e
complied with.
I certify that in the performance of the wor f r which this permit is issued I shall not employ any per-
son in any manner'ho 66 ff folate the workmen compensation laws of California. n y_
Ow er F. N. c_Address/D.G/i-J.% ..... ...-/......
Contrecfor�`
�..
Y o .... Address -... -------------------------
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Form 280-I
RECORD OF INSPECTION
FoundationFrame
.'.-G.��--p�-%'.C�tifi �'� ----_
Stucco ---------- ---------------- -------'--........_..----- Finish G—.5.. .-........`
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