40212 (2) xf �- Kr
itITY OF SAN JOSEc /vrwive BUILDING DEPARTMENT
APPLICATION FOR -BUILDINr? PERMIT
Tract No.J;�;Z 9--- Lot Nci.-' i�-----------
I
Date- ---------------- -------------------1 1 9 P mif No.4002... --------
Application is herebbad for a permit t ......-- ------------------------------------------------------------
a----/-------story, ...................... --- Buj*ld,'_nl
at - -------- Use Zcnek-'-)----5------
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sc I y
to be occupied only as --- 6ar 'nX�cci
in accordance with Plans. Spelicafironsend Plot-plan filed herewith.
Estimated Value of Improvements, ------------
lt 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 perfcrmance of the work for which thispermit o; issued I not employ any per-
son in any manna} f violet the orkmen's compensation Ca mi I
Ownas -zz -Iij-5tr
Address
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c,.tt'aEtor ByAgent - ---
..........Address ,1- -----------------------------------
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Form.280-1
RECORD OF INSPECTION
Foundation 3
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Stucco --------- ------------ ----------------------------------------- Finish
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