41176 (2) 7564 - Shaladwal`/ At
CITY OF SAN JOSE,/ , \ e BUILDING DEPARTMENT .
APPLICAT!?N FOg BUILDING PERMIT
Tra ------ ....... Lot No.
Date_..........._.....---_ ............. 19. .Y Permit No_ -------------
Application is hereby —made for a permit ---- ---- -
Building
Use Zone ----------------------
a-----------/--sto T p ----------......
- -
/...story
-----p --Cil-----
at -------- -------
"00,, W
to be occupied only as ...... ,�a Cc, --------
------------------ a .... ............
in accordance with Plans, Specifications and Plot-plan file erewif h.
Estimated Value of Improvements. $,.:�- -----.........0----4?.. .....
If 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 t ' let the workmen's compensation laws of C
GGGC'Aciclress,"� ---------
------------------------------------ Y - --------- --
-----------------------
rtre;;�
';As. ..—fill- -------- - ---------Address////----C/........ ... ............
Form 280.1
RECORD OF INSPECTION
Foundation 3 k"6 ��
- ------------------------------------------------- Frame .......
Stucco ------------------------
----- --------- --------------- Finish ----