46182 (2) 1614 steiifng a ,y -
CITY OF SAN JOSE PL4' /<" BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
0
Tract No.r3�.._S. :......Lot No...........................
Date... e --Z ....... ... 19_C? Permit No.--7.-�1( ✓� v-------
Application is hereby made for armit to .l L...:..
a-------/......story, Type- --`--''""-----..... ... . .. . ..Gam..----------.......---------- Building
Use Zone......A-1
cc u p a n cy.........------------
to be occupied only as 1. ......3h........... ng Space.......�-----------
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements,
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 parson in
any manner so/ s�t'oo violate the workman's compensation laws of California.
Ownesr ------Address
0��:/J�,. �r
ontr tor) z
By Agent A_>2,5� -c---- ---.........Address_ ................._..... --------------
RECORD OF INSPECTION
Foundation.. .. .. ........f9. .
......�.... Frame . -Z.. /—Gi:
Stucco..---------.................................... ..........Finish.—
Form 280-1—IOM-12-63