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CITY OF SAN 7iUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date---d---—--;7—4�7_/....... Permit No.-':�-7-6-0-44----
Application is hereby made for a permit toE
i2i
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a..-.---/..-----story, Type....iBuildingf-----
to be occupied only as
filed herewith.
in accordance with Plans-,4,ecifc,=i,,, ad Plot-plan f!§
Estimated Value of Improvements, $---- ......—----------
It is hereby agreed that the requirements of the San Jose Building and Zoning Ordinances and fall 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 performancoj of the work for which this permit is issued I shall not employ any per-
son in any manner to violate the workme'n's compensation laws of California.
Owner)�/ ------------------------- 1A
Address
BY -- ----
Address ----------------------------....................... ------
..
D. Schmid
Form 228-0-11. S' Stes
RECORD OF INSPECTION
Foundation -------------------------------------------------------- Frame -------------------------------------
Stucco --------------------------------------------------------------- Finish -7— /,:� (� /
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