36376 (2) C Sil ` OSE ' BUILDING DEPARTMENT
PLICATION FOR BUILDING PERMIT
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Date -------------, 19..42.-1.. Permit No..174 37-6--------------------
Application is hereby made for a permit to ---.b3-1J.LlL-----"----.-..._-------------------------------
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°------- -......story, Type--- ------ -- - --- ---------------------------------------".-.- Building
of --91�•-_7.... _/��`''f-F-....faG-c�.S.FS.21--�,e.. J1� // 'vim`� —/'
to be occupied only as
in accordance with Plans, Specifications and Plof-plan filed herewith.
Estimated Value of Improvements, $e/ ,d —60-:-------------
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 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 workman's compensation laws of California.
Owner .,,-.1ZC'.Address 1n6.2 - u--:��:a.� s� 27, .&+r 4e
B� -zo— ' ----- --------------------------------
Address --------------------- -------------------------------------...
Contr or, Agent
form 280.1
RECORD OF INSPECTION.-
Foundation .. . .... ... �rarne ------------
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3
Stucco ------"-- Finish
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