37463 1141 H611 h d
CITY OF SAN J�S ��Q 7 G BUILDING DEPARTMENT
APPLICA '06 FPX BUILDING PERMIT
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AJpplication is here b a for permit #o( f '..... ... -- -
a-----/----------
story, Type--------vl --C--- --- ------------------------------- Building
to be occupied only as _- �
in accordance with Plans, Specific s+i" o an o#-pan I erewlth.
G
Estimated Value of Improvements, $���.---... -t..-..--..
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 manner so as to violate the workman's compensation laws of Califo/nie. /
Own :: `�� jf= "�-s�G• ---Address/�.6- --- --
BY/ r' `/''4.n
�ct.r . , Addres ...: .....................
, Agent
Form 280.1
RECORD OF INSPECTION
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