38046 (2)6V OF SAN JOSE
� BUILDING DEPARTMENT
APPLICATION FOR B IL Me- PERMIT
Date- J- - ---------------------.. 19------ fermi No- ------
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Application is herebyjr3ade for a permit tp v` ------------------------_------
Building
at 74-6d
to be occupied only as/`l.� ! ` �� ��,�
in accordance with Plans, Specifirlon n tf p15�fil � wStH!
O -
Estimated Value of Improvements, $/
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
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 nn"r so to violIa -}he-workman's compensation laws of Cahfor
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111
B ....Address .- :-----------------------------------
Agant
Form 280.1
RECORD OF INSPECTION
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Finish
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