41176 (2) APOF SAN �6SEZi1 1 BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
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Tract N---...., 19.......-..6.Z j'.... Lot No.��-Permit No....._.........
Application is hereby a for ermi#(}�!..... .........................................' ...-------.-.
a......./-----story, TY - !U(�/............._ .._ Building
�7 q --.-.. PT �/JJ Use Zone �-----------------
to be occupied only as 1.--�.. 1'�.. � --... aFktn aoA4%------------------
in accordance with Plans, Specifications and Plot-plan f�erewith.
Estimated Value of Improvements, .:o.-
p s//s.. ..../
It is hereby agreed that the requirements of the San Jose Building and Zoning Ordinances and all other
laws applicable to the construction, locafion, and use of buildings within the City of Sen 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 nnei�n ayfo violate the workman's cor"pensation Addrezlaws of��:3s 9 , A�
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�C................. ... ...Address
Form 280-1
RECORD OF INSPECTION
Foundation Fram 1...-6.- -.L. ... 3 R W-z?
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