37309 (2) CITY OF VAN' J§O'StE" BUILDING DEPARTMENT
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APPLICAT'14L-9
0NFOR BUILDING PERMIT
Dafez6�., -------------------- flercrif No.--3-+7--.3.0-1-----------------
Application is hereby made for a permit G --------------------------------------------
a-------/-----Mory, Type - - -- ---- ------- --- ---------------- Building
at JiT..Y--------T-7-ZI-4.)....AK.a.........)_-d,+Z)
to be occupied only as
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, $------ --------lr--1:51 Z5)
------------------
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 per-
son in a aq r sQ,av4o v,,o,11.a4ttCalifhe workmen's compensation laws of rn/
wne M.0......................
................Address ---------------------------------------------------------------
Contr Agent
Form 280.1
RECORD OF INSPECTION
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