40020 (2) 76T'Y"OF SAN�WEs�WAR~ BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract Lot No. Z.�......
Date- .............------------------- 19&.Z— Permit No. Ll 0 0 1z 0
. . ............... ----------------
Application is her b ade for a permit to ---- ----
--------------- ........
a-. __story, Type:----- .. ...... --- Building
- - -- ---- ------- - -------- - ----- ----
at
iL.......
to be occupied only . .... ....... ......
in accordance with Plans, Specifications and Plot-planf* ?-I,
ad herewith.
J!
Estimated Value of Improvements, $// - ----------f.....
It is hereby agreed that the requirement, of the San Jose Building and Zoning Ordinances and all other
laws applicable to the construction, location, and use of buildings within the City of Son Jose, will be
complied wish.
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�o s t yiolate t c e workmen's compensation laws f C if -
ownn
--- --- ----
1 - ----- ------7--- ----
_ - I� ----"--
Conirecto
Addre, 4
ByAgt�/ . ............Address 'Y.................. --- -- ..
--
.......
--
-------
Form 280-1
RECORD OF INSPECTION
-/'�'� �d./ SQL . ../ / �b Z�: .� .✓F.i'�
Foundation ..._ _... . .. re .--..--.--1.� ��-
Stucco --------------
--- -...- -' ... ------------------------ Finish .....--- �( ...-- -------------- --------------