43790 (2) 1192 Stafftord
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Tract No._32$1.........Lot No...$$.................. / 2
Date............'.......-................. - 3.1..1'0, 19"-64... Permit No.`1 .J7-%U-"'"""----.....
Application is hereby made for a permit to ..._QQ..WM 9t..._._••••____.._____................_:
V l✓/1lld )iif17
a...........�..sto �TT.yr e------.....-----..,.....__............. ' ------...... ............................... Building
at 1192 Sta#rf pe
Drive d r Use Zone..R1' Q?L......
single family�ieSii�i✓/t/iOc9°gPncy......... - .......
to be occupied only as ........................................ (/ Parkin ace.........�....---.--.
in accordance with Plans. Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, $...19.-Q.QQ......---_-...... p�� �_ /S./s
It is hereby agreed that the requirements of the San Jose Building and Zoning Ordinances end a 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..Broo1�,•�ield---Cnr- .................. Address...-3.� 5.0-20th.._Aye.---S.F.. .
Con+rector �toneSon onst uct�ion
By Agent !t . . .:.--((_ AddressP:..Q.e"--Box...1 1,---San---Bruno
-07-1113am A ant' --
RECORD OF INSPECTION \//� /��7
Founda4ion-.._%l. -G�(..-'Gl.. ....4r....-_...-.Frame��.-9..�..-`.�.T� ...........................c[.�GvwS
v....-_ ..
Stucco ..................- ----Fini&hz1�. ...
-•---------------
Form 280-1—IOM-12.63