31276 (2) 868 Staking
CITY OF SAN JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
Date............... ------------ 19 Pe t ......---------
Applicati n is hereby made fora permit to--- -- ---- . . ...... ............................................
a_.........L---story, TypF_ ..rx ... Building
at................................. --- ...
----
to be occupied only as...... 4M....... . .......................
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, $----/5.>{ -
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 com-
plied with.
I certify that in the performance of the work for which this permit is issued I shall not employ any per-
son in any nner so as to become subject to the workmen's compensation laws of California.
g--?;erAol
Owner-- ---- --- d d r a s//
By-- --- ----------------Address------------------------------------------------------------------
Contractor. Agent Loma Verde Const .
Form "868 Stelling -.rR
RECORD OF INSPECTION
Foundation....... .........Frame.......q, /y,
.......................----------------Stucco---...--------------------------------------------- ...........Finish...
...........-
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