32339 (2) CITY OF SAN JOSE BUILDING DEPARTMENT
LOTlis --APPLICATION FOR BUILDING PERMIT
DEC 2 q�
Dafe-`---- .... . ...... ...... ........195 ...!' Permit No. 39 .... .....
bui:
d
Application is hereby made for a permit to.............bil.-/--------
.----------------------------
*..------------
N. ..........._..... . ........Building
a--------one---story, Type-------------'I ... - ----- -'-- -- --- --
Lot, ;:c, Il5 :'c.<r-:roam - l:ucl .1u, 25,--�s w JJ:'Cn 1•-i
at........—...._..._--..-.-.—.—.....- --...
oae :>.I;r fl:.e17 ��-1---
--- ---------- .
to be occupied only as................ - ...
in accordance with Plans, Specifications and Plot-plan filed herewith.
Estimated Value of Improvements, $.....� ..QQ-O.-.......-.
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 corn•
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 manner so es to become subject to the workmen's compensation laws of California.
'=- ----
-.:.- ..:...
................Address----------------------------------------------------------
Owner......
,
1, s._4_r ,_. .. �..:.............Address................
Contractor, Agent
i
Form 2804 \.
RECORD OF INSPECT!
Fouin
s+�