38563 (2) C1419F SAN JOSE a�f - BUILDING DEPARTMENT
APPLICATION
FOR BUILDIN PERMIT
Tract No. 1....`x/....9 Lot No. ..... QQ
Date---S O................................. 196..v Permit No.
Application is hereby-,made for a permit 4
/ story, YP ,/ ---------------- ------------- -
at -`1r7 pp pp B, /L!� Use Zone .._-.------.-;`-
.-`-5----0...0---- ------ -- --- -------- -- -
Occupancy ......................
to be occupied only as .. .../._.... y � a2r i S ace ....._...............
in accordance with Plans, Specifica#ionf�/5nd"'Plof- a �Tie�re
Estimated Value of Improvements, $../../5�� ..
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 Son 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-
sonin any me oe;, 7 violate t e workmen s comp nsation laws of Celifornie
ress
Contractor )%(' ['' Address
Form 280.1 /
RECORDOF INSPECTION
�ounct& $ - Yf. .:.L.
� U 0.---'----------------- ----------------- -- Finish ...-- --- f. j---- .,._LZ .E 2