77781 (2) 874—'76 Milolera, /c
CITY OF SAN JOSE BUILDING DEPARTMENT
AP/PLICATION FOR BUILDING PERMIT '7
Date------ ----- ---�-----------------195. 3 Permit No.- /-.-
� pp
Application isihereby ma for a permit to---------16`.�---_...._.�.j__..._..._---------------------_---
a-----------�----story. TYpe.. .�........../.� .............:�--.-r/ ---`'�"`.g-��------.Building
at----------- . - ----- - l --� ....... ----- - -----------------
to be occupied onl ._ 7-.... - - - ---.51--------- --L --- 1--'-.1-_5. ..--------
in accordance with PI ns, Specifications and Plof-plan filed herewith.
Estimated Value of Improvements, $/..`.�.Q.. ._D-
If is hereby agreed that the requirements o the San Jose Building and Zoning Ordinances and all other laws
applicable to the con tructio�and use of buildings within the City of San Jose, will be co sp�lied with...
Owner------------------- ------- - -Address-----At... 1-------------------------------------------- -
BY ..... - ... . - . :............Address. - ------- -------- ------------ '
Con}rector, Agent
�l form 280-1 874=`76 Miller _?_ - s-F 0 F. Shoemake
RECORD OF INSPECTION
Foundation....
........................................... Frame,
------------------------------------------ .............
Stucco.....................
......................Finish
4 .2 '3--3