46022 (2) 6�0 shady dew6 T
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract No.......................Lot No.......................... /
Data /:. 19..41 PermitNo. �l iv 0.7 Z
......................
Application is hereby made for a permit foxx;2-�...........
12 ,
a.........p------story, TYPB--J`------R-- ------- - --- --- --- ..f&,.0........................ Building .
at ... =- �esuv<ei dAPAA7Jo se Zone--�l�--------•
�upancy.._:L-------------
to be occupied only as ff�..................1�/ � g Space---_?n—.............
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, $---3-LLP..........................
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 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.
Owner ..L.P.l+ ..W.:.. /74.4.-----------------------Address..... e2-IK7.SH9Q
By Agent--........
...............
... ............�.. ... Address ... �ZF
6247 Shady Grove Tom W. Ra,a
RECORD OF INSPECTION
Foundation......................................----------------.Frame.........--•--------`/.------..
Stucco.........-------...---•--•.............----...................Finish. .'�'G�c�
z4l"'e�✓Qll ti
Form 2801—IOM-12.63