30838 (2) 843
CITY OF SAN JOSE BUILDING DEPARTMENT
ti APPLICATION FOR BUILDING PERMIT
Date Permit 1�10.......... ---------------77.......
--------------------------------- �O
Ap laflo is hereby mad for 3 permit to........11-%eo�475 I ..........................
--------/........sfory, Type— ---- ------ --- ----- ---------------------------------*Building
a---.../........story
-.17
M-1— --- -- --------��-----:...-.......... .........---
to
................ ............
t.................. 4C;k--T.. ... . - s'.- . — -_ :....
to be occupied only as..... .. - - -----
in accordance with Plans, Specifications and pI n filed a a
Estimated Value of Improvements, $../2.f _-
it is hereby agreed that the requirements of the San Jos; 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 inany manner so as to/become subject to the YOrkmen's compensation laws t California.
Owner.
By.... ....7.......
0.,4 .Address.. . ...... ---------------------------/........u
ontractor. Agent
For. 260-1 843 Grimm 6-1 59 Loma Verde const.
RECORD OF INSPECTION
2 -,)-T
Foundation...................I........-.......................... Fra .........2-3 --9-9
Stucco............
--------------------.............................Finish........-5
. ..................... .. ....................
3377.3