37957 (2) W. �'c�DBYtAhis R:- J: fi�litLi" �C Ari§06:
OF SAN JOSE �19A, BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date..,;. 1 -119Permit No..
7-y--. ---7--------------
Application
------------Application is hereby m de for a permit fo p�
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a-------/------story, Type. :....---- r�'1 -----------. Building
to be occupied only as :`.-------- -
in accordance with Plans, Specifications and Plot-plan i herewith.
Estimated Value of Improvements, $../.�.'... _ (_--------------
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.
1 certify that in the performance of the work for which this permit is issued I 'shall not employ any per-
son in any mann r so as to violate the workmen's compensation laws of Cal for - f
Own4rl.: -- Gc(,,'�,Address/L'1 / J . fin. I/ /
T �.
BY 1�..1.-.-+ J �G�I/-i(� - - .Address ----- - -
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Contractor, Agent
Form 280-1 -
RECORD OF INSPECTION
r6o-,,-n,d?qT on
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Fo d t' ,Zra m oe
S Finish ----- ------------ 2,
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