30656 (2) 76!x. Eriri
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION F R WING PERMIT
Date .......:........119 Permit .............. -
Applic tion ii, hereby mad for a pemii to------ . ...........................................
a---....../--/
........ ....story, Type...-.9 ...... --------------------------------------------------Building
t..........7.l;�/-3................ --------------
to be occupied only as..... ---- - --------- --- ---- -------
in accordance with Plans, Specificati s —4o - ne er
Estimated Value of Improvements. $-/z�- --------------
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.
certify that in the performance of the work for which this permit is issued I shall not employ any per-
son as to become subject to the workmen's compensation aws off
f aliforma.
son in a�n nne;.,si
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Address------ .......le-ft---------------------------------------------
Contractor' Agent
Form 280.1
7613 Erin Loma Verde
RECORD OF INSPECTION
Founda+ion..-- .- '... Frame .... -----------------------
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Stucco...... lYFinieh.... w%
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