38046 (2) iC g OF SAN JOSE r'� PL�c� BUILDING DEPARTMENT
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APPLICATION FOR CBUILDI[dG PERMIT �( /
Date--[../...�.. ------------------- 19_ .Y 9Pe i No.---- -.------ lO
Appplication is hereby de for a permit to ... --------------------------------
a--------/-----story. Type9,l_ ----- ----- ------- -- - - -------------------------- Building
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to be occupied only asx_.!�.Z - is
in accordance with Plans, Sp itaasV it ewith.
Estimated Value of Improvements, $�,!-------------------/--------
If is hereby agreed that the requirements of the Sen 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 that in the performance of the work for which this permit is issued I shall not employ any per-
son in any manner soo as to violate the workmen's compensation laws of California. W
Owne ? /✓ u' !i P -�l �®Address G -- - —�
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��C`i"rc�redw Sant V
Fnrm 280-I
RECORD OF INSPECTION
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