34594 (2) 0#46. M66t4ffih 15V6
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date-------41 -------agr---------------- 19 G DPermit No------
Application is hereby made for a permit to ------- d 7�-c------------------------------------
a.-- - ...sfor� , Type-----j�Zry1��yJJI(--- --F?4o:-V--------- Building
at ----- ..... �1 �110
C4t4M.,
to be occupied' only as ....j Fi 4 ?
in accordance with Plans, Specificati n, a 104-4s4 el
0
Estimated Value of Improvements, --3-,7.
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 any per.
son in any manner so as to violate the workman's compensation laws of California.
I----------
----.Address-P. 3.7D---
By ------------------------------------------------------------------------Address ------------------------------------------------------- ----
Form 280.1 207 ftplrackbitget"Lan Mrs. M. Lucchetti
RECORD OF INSPECTION
Foundation .................................................... Frame ---------------------------------
Stucco ---------------------------