41993 (2) rt
CTrY OF SAN JOSlt* BaIker,� I BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT &-OZez-�
Tract No_?��42�__ Lot No. -S-T---------- D ,5 -719
Date..._ ..JUfi---2-8 4963------------ --- 19 Permit No.!Y1 9 f-3--------------
Application
-3------------- -
-------- .... ''
Application is hereby made for a permit to .... ................... ------------ -
a----h: sfory. Type.- ------ 4,1 '09 ----------------------- .... Building
---- - ------ .......W
Use Zone ...
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---- ----
at - --------------------------- .... ...... -
Occupancy X----------...
to
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to be occupied only as -------------------- .. ......Awvt/��rking Space _=r:........_......
in
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in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, ........
It is hereby agreed that the requirements of the Son 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
complied with.
I certify fhat 'n/ performance of the work for which this permit is issued I shall not employ any per-
is
son in
n man r P. as olate the workmen's compensation laws of California.
Owner ........Address �PPHVLTE_-.CAMR.j3E-V,-c-,0;-
or
Contracmr 2633 SO. 13ASCOM
ByAg.ni-------------------- -------------------------------- ------- --Address -------CAMPSEA-L; C*LIMRrTrA---------
Form 280.1
gqRECORD OF INSPECTION
Founda#ion ..T..2 ..D.. -- F,am e—m../..n „ 6...�`. _�`" 77.......... -
Stucco ----------------------------------- ................ Finish
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