40020 (2) 7( 1 OF SAN-70SE7 BUILDING DEPARTMENT
APPLICATION FOR BUILDING�ERMIT
Tract No.S'04Y Lot No.
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Application
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Date ............................ ..----._19-------- P
Application is hereby/made for a permit f -----------------........................ ---- --- - -----------
.5- � ---- Building
a....---/-.....story, Ty � �' -_ - -------- *. ..... ..............................i�i I
at .7.5-01 (3c�'L�� Use Zone IN- -----------
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'-Af-f Occupancy ---- -- ---
to be occupied only as .. ........ . I--------------- Parking Space ... -----------
in accordance with Plans. Specifications and Plof-plan filed herewith.
—e e3�L
Estimated Value of Improvements, $.11.4. ..........t ------ -
It is hereby agreed that the requirements of the Son 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
complied with.
I certify that in the performance of the work for which this permit is issued I shall not employ any per.
t °'r olat:e workmen's compensation laws of California
son in any moon rf� wor m
n
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Form 2801
RECORD OF INSPECTION
Foundation ------
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Stucco ..............
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