31079 (2) 7639riiri
CITY OF SAN JOSE BUILDING DEPARTMENT
A PLICATION. FOR U BUILDING PERMIT SDS
Date----- -x------------------------------ Permit No. ..7...�?----------
Applicd?.on is hereby made for a pe mitt
to.... .. ..........................................
story, Type--- .... .. ..... ..........................................Building
----------
f..................... . .. . ........... ........
be occupied only as...... . .................. ..... ---- ----
in accordance with Plans, Specifications and Plo Plan a
Estimated Value of Improvements, $------13. ...........
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 in any m nor so as to become subject to the workmen's compensation laws of California.
Owner- w.. ......Address./1..
4W
By....... - „�,.?S ee-4.........Address.---- _ -----...------------------------------------------
Contractor.'Agent
Form 280.1 7639 Erin Loma Verde Const.
RECORD OF INSPECTION
Foundation---- ------------------------
----------------------------Frame.. ------
Stucco
Finish............
;p
0-3/