33039 (2) bAAtkW._.S%_..._.._WESTLYN #2 TRACT 2168
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date .. ........................... Permit ...........
CONSTRUCT
----- i " i" by made for a permit to..........................................................................
Application is
a--------.`-------.story, T 0; ........................-.Building
... . .....
at......... --------------------------------------------
.......................
iING E F ILY RESIDENCE
to be occupied only a E ------2.... ----------------------------------
-------�p......
in accordance with Plans, Specific 10
Estimated Value of Improvements,. ..,- 2-10,0a.......
It is hereby agreed that the requirement, 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 com-
plied with.
, certify that in theperformance of the work for which this permit is issued I shall not employ any per-
son in any manner so .1 to become subject to the workmen's compensation laws of G�lifornia.
Owner--- ------ ..... - -------------- .............Address----/_�-_, ..?;�C121
By......... ........Adclre's.. 44_. _,
Confractor.kA ant
Form 280.1
RECORD OF INSPECTION
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