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35686 (3) BUILDING DEPARTMENT APPLICATION FOR BUILDING PERMIT z..... Date..... --------------------------------------• 19.41—. Permit No.-------}._ .. -.....-..-------- -- - Application is hereby made for a permit rmit to ---------------------------------------- - - -Building .5... ' ----------------------------------------------------------- .......-'t------story, Type--..--9...... at ... . ...... a to be occupied only as ---- ... with. in accordance with Plans, Speci i" n4 .A a, Estimated Value of Improvements. $........ nt, of the San jose Bu in g and Zoning Ordinan c,s and all other It is hereby agreed that the requireme. an j.sa, will be lawspappjicable to the construction. locati n, and use of building, within the City Of S ploy any per- com tied with. of the work for which this permit is issued I shall not a I certify that in the performance son in any manner so as to violate the workman's compensation laws of California. .............. 0y ..............y. ...Address. Owner 7� ........................... Address ------ Cp�ractcr, Agent Form 280-1