38446 (2) iler
BUILDING DEPARTMENT
WY SAN JOSE I :1 �
APPLICATION FOR BUILDING PERMIT
2 (. 4
_
No. . ... . .... Lot No. - _ __ -
Date...... CP_fn...Tracf.............. ......1 19------.. Permit No. ---------------
Application is hereby made for a permit to _&U-D -- -------
a-----,--.....story, ------ ........ ...- -----------. Building
at _.[10.3/1_ --------------
Occupancy t / e A� Use Zone __K Z-
Occupancy Xl---------------
to be occupied only as FA_0__A6 --------- Parking Space L.__.._...__..
in
--- -------
in accordance with Plans, pecifications and Plot-plan filed ha with.
Pec"'
Est ad Val m o eme f 0
.ir n s i u JAdamcesyamcl�afl other
n)et j
�)a t, le—k
, hereby 8,, h nt fan se "In
le'r n �a n n
t tr. n location,
)Iul g 4�4
r,c n, location, and use of u;d! s within the City of San Jose will be
CN�Zjf.
I &
.r�
that
I car ify that �ithe 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 workmen's compensation laws of California.
Owner ---&ir, ----------------- ---Address ...4 q_6..-...5)
�
,7
Contractor
ByAg.nt r ------------------Address ------- ------- ------------ -------------
Form *�*-913 Miller Av.e. Alfred F. Davis
RECORD OF INSPECTION
Foundation ..... --- .32-A/C _/rarye�-C.,Y--- --✓..."--�L-�!---_L.y"-'-UG.h,,
Stucco ---------------------....------- -...-� Finish -re-.
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