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40020 (3) 'CW OF SAN'J S � t/� BUILDING DEPARTMENT APPLICATION FOR BUILDING PERMIT Tract No ..._ .. Lot No./ �-.......... 0 2 Date! `� . ......--.. Application is hereby ade for a permit + v........................................... -------------- / a......./j ....star TYPe:c .........................................................- --- Building at .r...... _J-. F?7 __......... Use Zone --- -------------- 1 J / {i �rPCC Occupancy ....Z-------------- to be occupied only as ...... .................. Parking Space .-..-a............ in .accordance with Plans, Specifications and Plot-plan filed herewith. Estimated Valiie�of Improvements, $./....(..J---- �i..../-- If is hereby agreed that the requirements 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 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 an per- son in any mannof so as to viol>f,the workmen's compensation laws of Celifor �/ ._...--.. ... Y Owe �✓ GC't{..'.64..y.. c....Address,4 s/ "--L�.0�.. / ConfracM> - ByAa.n�. � f�-= c « ..._------------- Address; ......... -- Form 280-1 f