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CIS OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
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Date_ 19-
----------- Permit No. 7.��3....�------- ------
Application is hereade fora Permi+ t
a....../-------story, Ty e G! e :.... - -- �--------------------- Budding
i
to be occupied only as
in accordance with Plans, Specifications//and Plot-plan fi - herewith.
Estimated Value of Improvements, $..L.�. -_ n-
+-----. ...
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 theperformance of the work for which this permit is issued I shall not employ any per-
son in any mender so as to violate the workman's compensation laws of Coliform
Owne .,:
r :. /GGaf.. r�i1Lo-C-.....Address/nlo,.l.l::lL.::.t«"t ,
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By -rW = Address j�- -- - ---------------------- ....
Contractor, Wt
Form 280-1
RECORD OF INSPECTION
Foundation
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