40368 (2) CITY tlVpe/ Drr
CITY OF SAN JOSECres-4-
� BUILDING DEPARTMENT
APPLICATION FOk, BUILDING PERMIT
Tract No.jo
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Datezz
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Application is hereby rnade o a per it t ----- ...... 7------ ----- ---------------------------------
---------------------- Buildin
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ancy ---- -to be occupied only eAFC"u! 0 .......L--------
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in accordance with Plans, Specification an Plot-plan - f
Estimated- Value of Improvements, -_ --................/...-............
If 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 pericrmance of the work for which this permit is issued I shell not employ any per.
son in any mapner)so as_IV�Iolafe the workmen's compensation laws of California.
owner4___�_
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Form 280.1
RECORD OF INSPECTION p
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