38944 (2) Tiptoe
CW`06 SAN JOSE BUILDING DEPARTMENT
z. APPLICATION FOR BUILDING PERMIT
Tract No- -------------------- Lot No. --------------------
Dat ...... f 7 1 19-- Permit No. --------- .......... ....
.... .........
'�"b made for a permit
Application�1 �er
a------I....--.story, TypCJ7— ---- Building
Use Zone
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10 Occupancy
to be occupied only as ..._l-.. ... P , i ----- ----------
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in accordance with Plans, pec�ificati n, an PI,4/>,1a,'n6i ad' hreiwi X6 '-A
Estimated Value of Improvements, $.....--.41�--------60---
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It is hereby agreed that the requirement, of the San Jose Buildingd Zoning Ordinances and all other
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laws applicable to the construction, location. and . of buildings within. the City of Son 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 a, to violate the workmen's compensation laws of California.
Owner Address
Contractor
Address
ByAg.nt.---'/--
Form
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F..m 280-1 7540 Tiptoe Pqt-rjj , 14 Lisin
RECORD OF INSPECTION
Foundation ------- ---------------------------------- .... ...... Frame --- ------- -----------------
Stucco ---------- ---- ------- ----------------- -------- -- Finish —3:.
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