41562 (2) JA40OF SAN JOSE'bbihd@LL• Wy+ BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract 'No. - ----. Lot No. -------------------
Date..
-------------Date.. ../ .. J .!.. 1�
........ . --------- 19----....3— / Permit No...7................... -
Application is hereby made for a permit to ./44r--Fc-z...------_---...... .....--
a.....
.a_.._ -------story, Type,.( —. - Building
Use Zona ......................
l.�'qY&) eng S ncy ......
to be occupied only as .1_FA.n.----_.-- - . - .Z.. mg Space ............__:._
T Fq�,.rr,_Y ��. ) � ,
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, $----..7.V 0
.
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 Son 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 workmen's compensation laws of California.
Owner ---k.------ ----- AddressI-i --,G...............................
te -, T/l.._ 2P .....Address .............. .. -- .......... ..............
Form'280.17890 Robindell Way M. Wasilko
RECORD OF INSPECTION
Foundation _ Fra e?� - �'"� ...c3
_....._.. .. - --------------- ,. ......... ..._.
Stucco -------- -...............
--- --------..... Finish /0-22�G.5�
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