33029 (2) 113 NAY 6k
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CITY OF SAN JOSE BUILDING DEPARTMENT
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APPLICATION FOR BUILDING PERMIT
Date---------------------------------------------------- 19 J-----0
... Permit No.9115e? f-----------
Application is hereby made for ermif ------ - ......... --------------------------------
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to be occupied ----------
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in accordance with Plans, Specifications and Plod-plan filed herewith.
Estimated Value of Improvements, $.--_/i/_.a0----.....
It is hereby agreed that the requirement, of the San Jose Buildingand Zoning Ordinance, 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 performance of the work for which this permit is issued I shall not employ any per-
son in anFyanne ?. violate the workme
r ns compensation laws cf�c 1W
a.
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noRECORD OF INSPECTION
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