30504 (2) 88� Lonna
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION F �BING PERMIT fry'
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to
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in accordance wi+ Pla s, pecifications 1 1 ed e .
Estimated Value f Improvem ts, ..(.
It is hereby agree that the r q ram is of t e San Jose Building and Zoning Ordinances and all other
laws applicable to t constru ion, to tion, a d use of buildings within the City of San Jose, will be com-
plied with.
I certify that in the ormance of the war f which this permit is issued I shell not employ any par-
son in any anner so a/sstt become subject to t orkmen's compensation lawns of California.
Owner. .. . _.. .Y . .....K. Address/
1.0
....Address..................................................................
BY......---- - Contractor, Agent
Form 160-1 '
885 Lonna Loma Verde Const.
RECORD OF INSPECTION
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