31276 825 yitA Lo
CITY OF SAN JOSE . - V__� "� , BUILDING DEPARTMENT
APPLICATION FOR BUILDING PERMIT SV ;9--
Date------------ ----- ------ --------------- 191:_017 Permit No. a ------------------
Applica ;,on is hereby made for a permit to
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a-----------/-----story, Type-- ---------- ---------Building
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to be occupied onlyI..........
in accordance with Plans, Specifications and Plot-plan 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 com-
plied with.
I certify that in the performance of the work for which this permit is issued I shall not employ any per.
son i as to be5pme subject to the workmen's compensation laws of I California.
any ma er so T
Owner_-. dress /
dress------ ---I--------At Ale
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By---.
Form 280 Contract Loma Verde
'1825 Grimm 7—,2
RECORD OF INSPECTION
Foundation-
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Sfucco...............
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----Finish..----/-..V.
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Y.2 69