34395 (2) JOSE BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT
VDafe--- ------------7-'------------ Permit No.
Application is hereby made for a permit to ----- -----------------------------------------
a........(........story, Type---V,�...yz`- ------- ----------------- Building
at ---- ...............Tile.....7...
to be occupied� only as94AYq-----------
`ao�C
in accordance with Plans, Specifications and Plot-plan herewith.
/Estimated Value of Improvements. $... 0
it is hereby agreed the+ 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 manner so as to violate the workman's compensation laws of Calif ornia.
OwnerAddress -------------1----- --------------------------- -
L/BY ------------------------------------------� ........ ........ ddre-ss ............. ) ...... ..... -------------
actor, Agent
Form 280-1 752fliptoe Eugene De La Cruz
RECORD OF INSPECTION
Foundation
-- - Frame ......... 2-
----------- ----------------------
Stucco ----- ...
--. Finish - - ----------------------- -----------------------------
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