92038 (2) 6212 SHADYGROVE DR.
UBC 1971.'
Tract No. Lot No.
CITY OF S N JOSE BUILDING DEPARTMENT
APPLICATION FO BUILDING PERMIT 9� 3�f
Date_ Z�—, 197 Permit No.
Application is hereb me foer '
a story, Typ + _J�-� i U one
at _fN Occupancy /
to be occupied only y
Fire
in accordance with Plans, Specifications and Plot-plan 'I erewith. Emer. Eli t
Elect.
Estimated Value of Improvements, $ 9600
I certify that in the performance of the work for which this permit is issued I shall not employ any person
in any manner so as to violate the workmen's compensation laws of California.
OwnerjC L,e CiE SM/T"// Address 62/4 -S-T.
By 1e4,m 4,0 7ARi9vTOc p Address Z7-776 NJEed¢✓LrJa�
ECORD OF INSPECTION
Found -afio - Frame44 04Oe� �
Stucco Finish�f�'i6 71le- /Di-
260-60IN
6212 SHADYGROVE DR. GEORGF. SMITH' -
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