35938 (2) 64§ Phil
CITY OF SANJOSE-;`�
BUILDING DEPARTMENT
APPLICATION FOR BUILDING PER'W
I ,e, 3 /-#e
Date...... -------I iq_1�111 Permit No -------------
Application is hereby made for a -permit -- -------------
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a-----/---......story, Type �`W- __1....... Building
at ..........e_Yy-------------------- ---- R27
to be occupied only as ----------------
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, dr
----------------
It 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 wish.
I certify that in the performance of the work for which this permit is issued I shall not employ any per-
son in any rrgjr sms to violate the,workmen's compensation laws of California.
c er domes, Inc.
Owner ----2151 St. Francis.Drive .....................Address --------------------------------------------- ----------------
............ ...........
Address ----------------------------------------------------------------
By -----------
Contractor, Agent
Form 280-1
RECORD OF INSPECTION
Foundation
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Stucco ------------------------------------------------- --------- Finish - -----------------
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