34585 (2) A9� KAh�wbdd o T �2
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date z / -------------------------- 19. .. - �..../P�erm f No.....34's-Z's..---------
Appliiccation is hereby def a permit to L/-���J./ .........................................._ -.
a.------- ----s+orY, TY,P� - ------ -- - ---- -;.'...+r------------------------------- Building
at ��..%.'�....../
to be occupied only as 1.... .....�!-_L.-
in accordance with Plans, Specifications
and Plo+-plan jd_herewifh.
Estimated Value of Improvements, $. c%Q�d v
......
It is hereby agreed that the requirements oft , 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 e7enn r so es to violate the/workmen's compensation laws of Celifornje, M1
� --'-Address ./102-10 S. JI/ ... (ti Ct
@Y �� n c C Address /`J--- -/
Contractor, Agent
Form 280-1
RECORD OF INSPECTION
Foundation �Frane ----- - -- -- -------------------------------------------- --
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