30504 (2) 605 Lei=
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION F IL ING PERMIT
Date.. ...... Permit No---------
------
Application i's hereby madefor lalermit to-----a:4W, -----------------:...................... ........
7- eV �
/----------story, T —V—.A....... - ——--- ----------------------- -------------- ..........Building
=0---- ...... .._-------- .. ........... ........
to be occupied only as-......... - - ------ .. ..... ---------- --- ---
in accordance with Plans, S ecifi tions and Plo ile h e i
Estimated Value of Improve ants, $
It is hereby agreed that the r quirements hn a uIlding and Zoning Ordinance, and all other
laws applicable to the consfructi n, locatio n use a buildings within the City of San Jose, will be corn.
plied with.
I certify that in the performan of a work for
h ch this permit is issued I shall not employ any per-
son in any manner so.as to become Oct 0 t a kr an's componsa.tion laws of California.
ldress//X47444 A 4
f &f
Owne
44P -----Address.......----------- --------------------------------------------
By..... &h
Contractor, Agent
Far. 280-1 805 Loma Loma Verde const.
RECORD OF INSPECTION
Foundation-------
.........[vwr...........
Stucco............................
............ --------------......Finish......17-z/..
trl 97