40113 (2) CITY OF SANz�r. BUILDING DEPARTMENT
APPLICATION FOIA/ BUILDING .P RMIT
os� 4`.....
Tract N _...----/---._ Lot No.�--. .--....---
Date. 0 .----- ................... 19V.. � '4 Permit No.-._40-1.)--.3-.-.----
Applicafion is here ede for a permi# fwd-/y-..`--..«.'..._..._-.-._...--._-._...--_.-...............
a-----/......story, TYP --- -. .. /lama..._..... .._..... .._..._.... .. .. Building
Bw
+ 1.-- - airy c � use zone
-------- - --...-.. ... -' ..... Occupancy . .
to be occupied only as - .............. . ... ......._! , k/A / ✓ Parking Space _:.--�ie-.---------.
in accordance with Plans, Specifications and Plot-plan filedrewith.
Estimated Value of Improvements, $-/.C.. S .. . --------
It
- -.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 Sen 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 rp violate the workme//n''s compensation laws of California _
Address --------- -..---_-.
Con}racror ,
' ByA9mr�.�:_fr��'���<..--..��....................Address -..,< .-. .:-- ----- ------------------------.----'
Form 280-1 1163 Crestline Dr. R. J. Hu I Assoc
RECORD OF INSPECTION
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Foun6tion ----
li Stucco ------.... 4o' "3 -/--9-'® -.7 A,;�d
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