39960 (2) (IW'011F SAN J!65�14>FW Aaeo BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract No. ---- Lot No. �----------------
Date ----------------------............ 19_4�v Permit No. --------
Application is hereby made for a permit to�_X_ ..... - ------------------ .......................
a_ story. Type.. _P -------------- ------------ ----------------- Building
at Use Zone
,/Occupancy ......................
to be occupied only as _2 ✓ 7__z� 1park,n"p4'_._6)1,,............
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, $ --------------- .............
It is hereby agreed fkat the requirements of the Son Jose Building and Zoning Ordinances and all other
laws applicable to the construction, location, and use of buildings within tlher.Cify 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.
I h workmen's compensation laws of California.
n i s
so w�e ....... Address,/
0
BCa� ..................
y go --------Address ......
Form 280-1
RECORD OF INSPECTION
Foundation .. CW/�.O �(J�rd,S.,��em�
St o -------------------- r/ Finish .............................Z1�cs%Lrl7
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