32240 (2)75'02 FIa11Arl1AAf
CITY OF SAN JOSE L-oTp- 2483 BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date--. k%-..-----'1"........................ 195-/. Permit No ....... 03. 2_2--y_d.........
Application is hereby made for a permit to...-- .5 .(--------------------------------------------------------
UN � � ....:-.::- :-i-......................................Building
a -----------E---- tory, Type----..�.:r...�[._S..::............_
at.----�-SU 2 .... P --------- -- ----- ---- -- ---- -- 2 -----------------------------------------------------
to be occupied only as.-----..4-N.k.. ..... .� t%�-
in accordance with Plans, Specifications and Plot -plan filed herewith.
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Estimated Value of Improvements, $--LUQ.- d � .....
It is hereby agreed that the requirements of the, San Jose Building end Zoning Ordinances and all other
laws applicable to the construction, location, and ruse ofbuildings 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 workmen's compensation laws of California.
Address----- .------------------------------------------------------------
✓gy t!Yl ia-..-...i<`/2 t+r rtki4S.Address------------------------------------------------------------------
Contractor, Agent '
Form zee -17502 Fallenleaf 11 ,, _� Newman &Vierra
RECORD OF INSPECTION
Foundafion ------
------ ------- - - ----- Frame ---------------------------------
stucco.-
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