30838 (2) 7574 Erni
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT GGid
Date-------- ... .. .......... ........195 ... Permit N ............7 p@�S
Ap/plication is hereby made for a permit to.-- .............................................
a.. I ......s+ory, Type--- _...................... --- - ---... . -----------------------------------
-
----- - - - Building
at----------.5?.. -.... �� - : �lU...........-
to be occupied only as----.... yam--..... ? .---....
/ -� �
in accordance wi+h Plans, 5 ecifica sons and Pot- le fi d ere i li.
Estimated Value of Improvements, $---/3-, --'•
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 San Jose, will be com-
plied 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 to become subject to the�Jrkmen's compeensat�jon la of California. �A
Owner _ �ffQ..PIv!!1-..Address. 41
l`T�<.- y f- ------- %dam/
1 .. __C-... .Address---------------------------------------- -------------.....-----
BY- -- `'`r
Contractor, Agent
Farm 280.1 7574 Erin h-_- �_Sy Loma verde Const.
RECORD OF INSPECTION
Foundation.......4�;,
......../.... .......—.......................Ic
rarnb......
- -----------------------------------
stucco-----------------------------------------------------...- -------""ish.... Z-el. 4"16
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