41817 (2) 9CITY OF SAN JOSE QW Haven Ct. BUILDING DEPARTMENT
, APPLICATION FOR BUILDING PERM -
Trac+ No.�5�L.1 �o+ r,o. �`�....�/1G( ��{� �.
pate.._ � �3..... ., 19..6.-3 Permit No..,..=/.-1��./-... -
. ...
I plicafion is hereby mede for a permi4 40 -�_ .-�" _.. .............._..._-..........---.----_-
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a....... .......stor � T e_�/'"�� .��.--�--�---'....----�-------�-� B�ding
, � Y YP --.._ _,�.__. ....
at .. 9 ,9 � .. .. ..��: �5e Zo�a _.....-...... -
l /'7 /y�j',� �J,J/� /��c�anry .Z - -
fo be occupied only as ./....�C���.. ...... t��:� d�/I/Pa?k�g Space ..�-------------
in accordance wi4h Plans, Specifica4ions and Plo#-plan filad herewifh.
Es#imated Value of Improvemenh, $,/.1�...��.--..--._..• '�
It is heraby egraed ihet ihe raquirements of ihe'San Jose Building end Zoning Ordinencas and ell other
laws applicable fo tha cons}ruction, lo<efion, end use of buildings wifhin�'fhe Cify of Sen Jose, will 6e
� complied with. �� .
� I certify thet in performence of the work for which ihis permif is issued I shell not employ eny per-
Ison in any mann o es lo v' e the-workmeds wmpenmtian lews of Califomia.
Owner .. . . _...;....._,.Address .SCk#UL��E=eAMP"�DEV:��CO.�
-_
Conindor � • � ��� ' 2633 SO. BASCOM
---_...'Address . - - _.
ByA9mf..'-.'................. _.._...........__'.._.... CA'MPOELL, CALIFORNIA.
I Form 200-I _
RECORD OF INSPECTION
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