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31276 (2) 874 Csii�srd KiYi CITY OF SAN JOSE BUILDING DEPARTMENT APPLICATION FOR BUILDING PERMIT 72 _119—.5-7? P re �i p,_.L...?-. -Q.?.......(0............... Date-------- .................... A i atior ppli ation is hereby made for a Permit to..--. --- --- ............ ............/-----story, Type-.-. ...................... ------------_---------Building at_........--"....-------------- ....... . ... .. ... ------------------------------------------- to be occupied only as....... ---- - - ----- -- ........ iE. ............................. in accordance with Plans, Specifications of-pla i he W Estimated Value of improvements, $__ _ - _41-". . . it is hereby agreed that the requirements oYThe 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 rp7ner so as to bac me si�kiecf to the workman's compensation laws of California' 0, WOE VAddres'- t 114 0 /000,� ner�� --- .. .... ....... . By... .........Address----------__--------------------------------------------------- Contractor. Agent r-orm 280.1 874 Grimm Loma Verde Gonst. RECORD OF INSPECTION Foundation----- ...............I-------- --..game-...... ll� Stucco.......-----.............- ...... -----------------------Finish----- ---------------- ........... LF