35938 (2) CITY OF SAN JOSE7
�UILDINr;r DEPARTMENT
41�O APPLICATION FOR BUILDING P
Date---- --------- 19.4/V*--- Permit No...i_�7__Yj6F-------------
Application is hereby made for it t le�_ �-------------------------------
_jL.permit o
Type...--
- ----- ---- --------- Building
a---------/_ story, ype... ........ - ----- ----
at -------------- -- ----------------------- . ... .......
to be occupied only as .... -------------
in accordance with Plans, Specifications and lot-)Ian 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 per-
son in any LjtNtFrTMegj&e he workman's c.mean'.fion laws of California.
2151 St. Francis Drive
own�e�r ._A. ;-t i ---------------------------_Address ----------------------------------------------------------------
---------------------------------------------------------------
-----------------Address
By
Cnt,.cto�Ager*
Form 280-1
' RECORD OF INSPECTION
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