37597 (2) & giibttAi0
64 fidhtilii� & AA666i
CITY OF SAN JOSE /x Al ^' BUILDING DEPARTMENT
r
TION FOR BUILDING PERMIT
Date./ �PPLICA
------------------------1 19TI11 Permit -------------
Application is hereby do for a permit to/
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Building
to be occupied only as 1_�1_;7-4
in accordance with Plans, Specifications and Plot-plan fil ewith.
Estimated Value of Improvements, s/
0
-----------4----- ......
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 s�s to �violate the workmen's compensation laws ofCal"fo , ,
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---------Address ------ ---------------------
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BorC
Contrac Agent
Form 280-1
RECORD OF INSPECTION
Fouridalw Frame ----- -AoL...�-/
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cco ---LFinish 21�
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