31276 (3) CITY OF SAN JOSE / BUILDING DEPARTMENT
�fA PLICATION FOR BUILDING PERMIT �'p Date.......... -.. ._? .... ----.., 19,_ Permi No.---
((( sal.
Applic tion is hereby made for a perrm to....1 .. -------------------------------------;-----;
a.--------.../_..story, Type... • - ' --------------------
Building
111 �----- --- ,
i
at----------------- --------------Ir
Z
4o be occupied only as...... . ........ ..e �/- .
4 .
in accordance with Plans. Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, / j --
It is hereby agreed that the requirements of�fho 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 com-
plied 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 so as ttoobb come subject to thhee/w Amen's
Ycompensationlaawsg California.
Own r.. 'V.....Address//pe-`:� �g.;e
/1"
By-%
-'r................Address.............------ ... - ...... - !
Contractor, Agent
Form °�6 Grimm
• �-_>_ -.2 Lama Verde
828 Kim Street
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR GAS PERMIT
Date. ...`.......... .............. .. 19./ ,� Permit No.....Q...Z33..(O.
The undersigned harebyV:wk£� �/� 9VP p actor of the City
of San Jos e for a ermit t es as listed on the
averse side he and agrees I install said appliances and/or pipes in accordance
with the provisions of Article VIII, Chapter 4, of the San Jos Municipal Code, and
other laws applicable thereto �L�J. iF7
I certify that in the perfo n of the w or s permit is issued I
shall not employ anyperson in any manner so as to violate the workmen's com-
pensation laws of California.
OWNER. Q�-- ,Fj1 cwtC............................ .......---------------------- _
ADDRESSl'J�/....�..... ..............................-... LOT NO................
• USE OF BUILDING- --......... . ......... ................ ..... - ..............
280.20 (Rev. Apr. 691 Signed_ ------
lam 4,,.2 .... s.. . ............ .
828 Kim Street Robbins Plumbing