33799 (2) 763'2 tr ih v,9 /—�� ,,
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR. BUILDING PERMIT
Date----------- -- ................. 19.
Permit No.-------
App,ca/io,%� hereby made for a permit to ------------------------------------------------I--------------------
story,
-- Buildin
----- -- ----------------------------- g
to be occupied only as
in accordance with Plans, Sp cificafi ns a t'plan fil ere
Estimated Value of Improvements,
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 wiikin'fka 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 i any nn r so as t iolate the workman's compensation laws of California/
jinanne ------- ------------------ Aciclress,?�S_ 4�4 Ace., &4�44IA44
..... .....
Owner W- e..... .....
.GUI .4.........................................
By .... .. ...... ----\------.Address -------------------I
form 280-1 763forti1ft Agent Palo Alto Dev.
RECORD OF INSPECTION
2- 7-
Foundafion ....... ---------------------------------------- --- Frame
Stucco ----:........................
-------------------------- Finish ... ............
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