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CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FO BUILDING PERMIT
Date.. 19_4_�_/
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Application is hereby Ta 0 ------------- --............ ..._`-..--._...-...........:...._9
da for
0 permit t��
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to be occupied only bs --------------
in accordance with Plans, Specifications and Plot-plan filed herewith.
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Estimated Value of improvements,
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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 th in the performance of the work for which this permit is issued I j shall not employ any per-
son in a"an or o to viol oo the workmen's compensation laws of Californ
cf, `A�.C.Aciclress/4r.
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...........Address
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Confracto Agent
RECORD OF INSPECTION
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