38563 (2) LDING .
CIT7566 Lo
Y OF SAN JOSE
C�RIION /FC7BUILDfNG IPERMIT Ev2/��T
Date.- /-------"--C--------------- 19`:-..1 Permit No.
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Application is hereby made for a permit to �
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._... _.....story, Type..-- - -------- Building
rfS �c �(/
at 6 - --to be occupied only as --.._.. ....-
in accordance with Plans. Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, d✓ � 05 _ ---
It ,
is hereby agreed that the requirements of the Sen 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 hall not employ any per-
son in any ma ar s to vio to the workmen's compensation laws of CaI for .e.
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BY t.-----%-------------I Address
Contra E or, Agent'
Form 280-I
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RECORD OF INSPECTION
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